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v1.0.0
ICD-10 Guide
ICD-10 CodesG95.89

G95.89

Billable

Other specified diseases of spinal cord

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

Code Description

ICD-10 G95.89 is a billable code used to indicate a diagnosis of other specified diseases of spinal cord.

Key Diagnostic Point:

G95.89 encompasses a variety of conditions affecting the spinal cord that do not fall under more specific categories. This includes pain syndromes such as neuropathic pain, which can arise from spinal cord injuries or diseases affecting the spinal cord's function. Autonomic disorders, which may manifest as dysregulation of autonomic functions like blood pressure and heart rate, can also be included under this code. Hydrocephalus, characterized by an accumulation of cerebrospinal fluid within the ventricles of the brain, can lead to increased intracranial pressure and may affect spinal cord function. Other nervous system disorders that impact the spinal cord, such as multiple sclerosis or amyotrophic lateral sclerosis (ALS), may also be coded here. Accurate coding requires a thorough understanding of the underlying conditions and their manifestations, as well as the specific clinical context in which they occur.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of conditions that can be coded under G95.89
  • Need for precise clinical documentation to support the diagnosis
  • Potential overlap with other spinal cord-related codes
  • Variability in symptoms and severity among patients

Audit Risk Factors

  • Insufficient documentation to support the diagnosis
  • Inconsistent coding practices among different providers
  • Failure to specify the underlying condition leading to spinal cord disease
  • Misinterpretation of symptoms that could lead to incorrect coding

Specialty Focus

Medical Specialties

Neurology

Documentation Requirements

Detailed neurological examination findings, imaging results, and treatment plans.

Common Clinical Scenarios

Patients presenting with unexplained neurological symptoms, chronic pain syndromes, or autonomic dysfunction.

Billing Considerations

Neurologists must ensure that all relevant symptoms and diagnostic tests are documented to support the use of G95.89.

Pain Management

Documentation Requirements

Comprehensive pain assessments, treatment history, and response to therapies.

Common Clinical Scenarios

Patients with chronic pain syndromes related to spinal cord conditions, requiring multidisciplinary approaches.

Billing Considerations

Pain management specialists should document the impact of pain on daily functioning and any co-existing conditions.

Coding Guidelines

Inclusion Criteria

Use G95.89 When
  • Coders should refer to the official ICD
  • CM guidelines, ensuring that G95
  • 89 is used only when the specific condition does not have a more precise code
  • Documentation must clearly indicate the diagnosis and any relevant clinical findings

Exclusion Criteria

Do NOT use G95.89 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

99214CPT Code

Established patient office visit, level 4

Clinical Scenario

Used for follow-up visits for patients with chronic spinal cord conditions.

Documentation Requirements

Detailed history, examination findings, and treatment plan.

Specialty Considerations

Neurologists should ensure comprehensive documentation to justify the level of service.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of spinal cord diseases, but G95.89 remains a catch-all for conditions that do not fit neatly into other categories. This has implications for reimbursement and quality reporting.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of spinal cord diseases, but G95.89 remains a catch-all for conditions that do not fit neatly into other categories. This has implications for reimbursement and quality reporting.

Reimbursement & Billing Impact

reimbursement and quality reporting.

Resources

Clinical References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Coding & Billing References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Frequently Asked Questions

What conditions are included under G95.89?

G95.89 includes various specified diseases of the spinal cord that do not have a more specific code, such as certain pain syndromes, autonomic disorders, and conditions like hydrocephalus.

How do I determine if G95.89 is appropriate for my patient?

G95.89 should be used when the patient's condition does not fit into a more specific category. Ensure that documentation clearly supports the diagnosis and any related symptoms.