ICD-10 Coding for Transverse Myelitis(G37.3, G04.8, G36.0)
Complete ICD-10-CM coding and documentation guide for Transverse Myelitis. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Transverse Myelitis
G37.3Primary Range
Acute transverse myelitis in demyelinating disease of central nervous system
Used for transverse myelitis associated with demyelinating diseases like multiple sclerosis.
Other specified encephalitis, myelitis, and encephalomyelitis
Used for transverse myelitis not associated with demyelinating diseases, such as post-infectious cases.
Neuromyelitis optica [Devic]
Used when transverse myelitis is part of the neuromyelitis optica spectrum disorder.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| G37.3 | Acute transverse myelitis in demyelinating disease of central nervous system | Use when transverse myelitis is part of a demyelinating disease such as multiple sclerosis. |
|
| G04.8 | Other specified encephalitis, myelitis, and encephalomyelitis | Use for idiopathic or post-infectious transverse myelitis not associated with demyelinating diseases. |
|
| G36.0 | Neuromyelitis optica [Devic] | Use when transverse myelitis is part of neuromyelitis optica spectrum disorder. |
|
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 transverse myelitis
Essential facts and insights about Transverse Myelitis
Primary ICD-10-CM Codes for transverse myelitis
Decision Criteria
clinical Criteria
- Presence of demyelinating lesions on MRI
documentation Criteria
- Detailed clinical notes specifying demyelinating disease
Applicable To
- Transverse myelitis associated with multiple sclerosis
Excludes
- Acute flaccid myelitis (G04.82)
Clinical Validation Requirements
- MRI showing focal demyelinating lesion less than 3 vertebral segments
- CSF pleocytosis (5-50 WBC/mm³)
Code-Specific Risks
- Incorrectly using this code for idiopathic or post-infectious cases.
Coding Notes
- Ensure documentation specifies the demyelinating disease context.
G04.8 - Other specified encephalitis, myelitis, and encephalomyelitis
Use for idiopathic or post-infectious transverse myelitis not associated with demyelinating diseases.
Applicable To
- Post-infectious transverse myelitis
Excludes
- Demyelinating diseases of central nervous system (G35-G37)
Clinical Validation Requirements
- Post-viral onset, negative AQP4-IgG
- MRI findings not consistent with demyelinating disease
Coding Notes
Ensure exclusion of demyelinating disease through documentation.
G36.0 - Neuromyelitis optica [Devic]
Use when transverse myelitis is part of neuromyelitis optica spectrum disorder.
Applicable To
- Transverse myelitis with AQP4-IgG seropositivity
Excludes
- Multiple sclerosis (G35)
Clinical Validation Requirements
- MRI showing lesion ≥3 vertebral segments
- Positive AQP4-IgG serology
Coding Notes
Documentation must confirm AQP4-IgG positivity.
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 Transverse Myelitis to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code G37.3.
Impact
Clinical: May lead to incorrect diagnosis and treatment., Regulatory: Non-compliance with coding standards., Financial: Potential for denied claims.
Mitigation Strategy
Ensure all relevant serology tests are documented., Review documentation before submission.
Impact
Reimbursement: Incorrect coding may lead to reduced reimbursement., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data representation.
Mitigation Strategy
Use G04.8 for post-viral cases.
Impact
Using G37.3 for non-demyelinating cases.
Mitigation Strategy
Implement regular training on code differentiation.
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 Transverse Myelitis, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Transverse Myelitis
Use these documentation templates to ensure complete and accurate documentation for Transverse Myelitis. These templates include all required elements for proper coding and billing.
Acute transverse myelitis in a demyelinating disease context
Specialty: NeurologyRequired Elements
- History of present illness
- Neurological examination
- MRI findings
- CSF analysis
- Serology results
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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