ICD-10 Coding for Pseudotumor Cerebri(G93.2, T36.4x5A)
Complete ICD-10-CM coding and documentation guide for Pseudotumor Cerebri. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Pseudotumor Cerebri
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| G93.2 | Benign intracranial hypertension | Use for idiopathic cases where no secondary cause is identified. |
|
| T36.4x5A | Adverse effect of tetracyclines | Use for cases of pseudotumor cerebri induced by tetracycline. |
|
Clinical Decision Support
Always review the patient's clinical documentation thoroughly. When in doubt, choose the more specific code and ensure documentation supports it.
Key Information: ICD-10 code for pseudotumor cerebri
Essential facts and insights about Pseudotumor Cerebri
Primary ICD-10-CM Codes for pseudotumor cerebri
Decision Criteria
clinical Criteria
- Presence of elevated lumbar puncture pressure with normal imaging.
Applicable To
- Idiopathic intracranial hypertension
Excludes
- Secondary intracranial hypertension due to other causes
Clinical Validation Requirements
- Lumbar puncture opening pressure ≥250 mm H₂O
- Normal CSF composition
- No evidence of venous sinus thrombosis on MRV
Code-Specific Risks
- Incorrectly coding secondary causes as idiopathic.
Coding Notes
- Ensure to differentiate between idiopathic and secondary causes.
T36.4x5A - Adverse effect of tetracyclines
Use for cases of pseudotumor cerebri induced by tetracycline.
Clinical Validation Requirements
- Documented use of tetracyclines
- Onset of symptoms following medication use
Coding Notes
Ensure adverse effect is clearly documented.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Papilledema
H47.12Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Nonpyogenic thrombosis of intracranial venous system
I67.6Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Pseudotumor Cerebri to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code G93.2.
Impact
Clinical: Incomplete clinical picture., Regulatory: Potential for coding audits., Financial: Loss of reimbursement for related conditions.
Mitigation Strategy
Ensure ophthalmologic exams are documented., Include funduscopy results in notes.
Impact
Reimbursement: Incorrect DRG assignment can affect reimbursement., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data representation.
Mitigation Strategy
Ensure to document and code any underlying conditions first.
Impact
Failure to sequence underlying conditions before G93.2.
Mitigation Strategy
Review coding guidelines for secondary conditions.
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 Pseudotumor Cerebri, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Pseudotumor Cerebri
Use these documentation templates to ensure complete and accurate documentation for Pseudotumor Cerebri. These templates include all required elements for proper coding and billing.
Idiopathic Intracranial Hypertension
Specialty: NeurologyRequired Elements
- Patient history
- Ophthalmologic findings
- Imaging results
- Lumbar puncture details
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
Need help with ICD-10 coding for Pseudotumor Cerebri? Ask your questions below.