ICD-10 Coding for Multiple Sclerosis(G35)
Complete ICD-10-CM coding and documentation guide for Multiple Sclerosis. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Multiple Sclerosis
G35Primary Range
Multiple sclerosis
This is the primary code for diagnosing multiple sclerosis, covering all types and stages of the disease.
Other demyelinating diseases of central nervous system
These codes are used for conditions that may be considered in the differential diagnosis of multiple sclerosis.
Key Information: ICD-10 code for multiple sclerosis
Essential facts and insights about Multiple Sclerosis
Primary ICD-10-CM Code for multiple sclerosis
Decision Criteria
clinical Criteria
- Presence of clinical relapses and MRI findings consistent with MS.
documentation Criteria
- Detailed documentation of subtype and disease progression.
Applicable To
- Relapsing-remitting multiple sclerosis
- Primary progressive multiple sclerosis
- Secondary progressive multiple sclerosis
Clinical Validation Requirements
- MRI showing lesions disseminated in time and space
- Positive CSF oligoclonal bands
- Clinical history of relapses and remissions
Code-Specific Risks
- Risk of under-documenting subtype and progression status
- Potential for incorrect coding if differential diagnosis is not considered
Coding Notes
- Ensure to document the subtype and any manifestations clearly to support the use of G35.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Multiple Sclerosis to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code G35.
Impact
Clinical: May lead to inappropriate treatment decisions., Regulatory: Increases risk of audit failure., Financial: Potential loss of reimbursement for lack of supporting documentation.
Mitigation Strategy
Ensure MRI results are included in the patient's record., Regularly update documentation with new imaging findings.
Impact
Reimbursement: May lead to lower reimbursement rates., Compliance: Increases risk of audit due to lack of specificity., Data Quality: Reduces the quality of clinical data for research and treatment planning.
Mitigation Strategy
Always document and code the specific subtype of MS if known.
Impact
Using unspecified codes when specific subtypes are documented.
Mitigation Strategy
Always document and code the specific subtype of MS.
Documentation errors, coding pitfalls, and audit risks are interconnected aspects of medical coding and billing. Addressing all three areas helps ensure accurate coding, optimal reimbursement, and regulatory compliance.
Frequently Asked Questions
Common questions about ICD-10 coding for Multiple Sclerosis, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Multiple Sclerosis
Use these documentation templates to ensure complete and accurate documentation for Multiple Sclerosis. These templates include all required elements for proper coding and billing.
Relapsing-remitting multiple sclerosis with active progression
Specialty: NeurologyRequired Elements
- Disease activity status
- MRI findings
- DMT compliance
- Complications
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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