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ICD-10 Guide
ICD-10 CodesChapter 6: Diseases of the nervous systemG31

G31

Billable

Other degenerative diseases of nervous system, not elsewhere classified

Chapter 6:Diseases of the nervous system

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/05/2025

Code Description

ICD-10 G31 is a billable code used to indicate a diagnosis of other degenerative diseases of nervous system, not elsewhere classified.

Key Diagnostic Point:

G31 encompasses a variety of degenerative diseases affecting the nervous system that do not fit into more specific categories. This includes conditions such as Alzheimer's disease, which is characterized by progressive cognitive decline, memory loss, and changes in behavior. Other degenerative diseases may include frontotemporal dementia, Lewy body dementia, and other atypical forms of neurodegeneration. These conditions often present with overlapping symptoms, making diagnosis challenging. Cognitive decline assessment is crucial in these cases, typically involving neuropsychological testing and clinical evaluations to determine the extent of impairment. The complexity of these diseases lies in their multifactorial nature, often requiring a multidisciplinary approach for management and treatment. Accurate coding is essential for proper patient care, research, and reimbursement, as these conditions can significantly impact the quality of life and require long-term care strategies.

Code Complexity Analysis

Complexity Rating: High

High Complexity

Complexity Factors

  • Overlap of symptoms with other neurological conditions
  • Variability in presentation and progression of diseases
  • Need for comprehensive documentation to support diagnosis
  • Potential for misdiagnosis or late diagnosis

Audit Risk Factors

  • Inadequate documentation of cognitive assessments
  • Failure to specify the type of degenerative disease
  • Misalignment between clinical findings and coded diagnosis
  • Inconsistent use of diagnostic criteria across providers

Specialty Focus

Medical Specialties

Neurology

Documentation Requirements

Detailed clinical notes on cognitive assessments, neurological examinations, and any imaging studies performed.

Common Clinical Scenarios

Diagnosis of dementia, management of cognitive decline, and evaluation of neurodegenerative symptoms.

Billing Considerations

Ensure that all cognitive assessments are documented clearly, including the results of standardized tests.

Psychiatry

Documentation Requirements

Comprehensive mental health evaluations, including history of cognitive decline and behavioral changes.

Common Clinical Scenarios

Assessment of mood changes in patients with neurodegenerative diseases, management of behavioral symptoms.

Billing Considerations

Document any psychiatric comorbidities that may complicate the clinical picture.

Coding Guidelines

Inclusion Criteria

Use G31 When
  • Follow the official ICD
  • CM coding guidelines, ensuring that the diagnosis is supported by clinical documentation
  • Include specific details about the type of degenerative disease when applicable

Exclusion Criteria

Do NOT use G31 When
  • Exclude conditions that are specifically classified elsewhere

Related CPT Codes

96116CPT Code

Neuropsychological testing

Clinical Scenario

Used to assess cognitive function in patients suspected of having a degenerative disease.

Documentation Requirements

Document the specific tests performed and the rationale for testing.

Specialty Considerations

Neurologists and psychologists should ensure that the testing aligns with the clinical diagnosis.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of degenerative diseases, improving the accuracy of diagnoses and treatment plans. G31 provides a broader classification for conditions that may not have been adequately captured in ICD-9.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of degenerative diseases, improving the accuracy of diagnoses and treatment plans. G31 provides a broader classification for conditions that may not have been adequately captured in ICD-9.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of degenerative diseases, improving the accuracy of diagnoses and treatment plans. G31 provides a broader classification for conditions that may not have been adequately captured in ICD-9.

Resources

Clinical References

  • •
    Alzheimer's Association
  • •
    American Academy of Neurology

Coding & Billing References

  • •
    Alzheimer's Association
  • •
    American Academy of Neurology

Frequently Asked Questions

What types of conditions are included under G31?

G31 includes various degenerative diseases of the nervous system that are not classified elsewhere, such as frontotemporal dementia, Lewy body dementia, and atypical neurodegenerative disorders.

How do I determine if I should use G31 or a more specific code?

Use G31 when the specific type of degenerative disease is not documented or when the condition does not fit into other specific categories. Always refer to the clinical documentation for guidance.