Neurosurgery Coding Alert

Question: What diagnosis should we assign to neurogenic claudication? Iowa Subscriber Answer: ICD-9 does not include a specific diagnosis for neurogenic claudication, a term that means claudication accompanied by pain in the back, buttocks, and lower limbs. Discuss the case with your physician to get a better understanding of the condition so you can choose the most accurate diagnosis. Here are two possibilities: • Neurogenic claudication usually is associated with lumbar spinal stenosis, so some coders recommend 729.5 (Pain in limb). However, 729.5 best represents lumbar stenosis, so that might not be the best choice for neurogenic claudication. • Other coders opt for 443.9 (Peripheral vascular disease, unspecified) if you know peripheral vascular disease is documented as causing vascular claudication, which can mimic neurogenic claudication.