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v1.0.0
ICD-10 Guide
ICD-10 CodesChapter 6: Diseases of the nervous systemG96

G96

Billable

Other disorders of central nervous system

Chapter 6:Diseases of the nervous system

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

Code Description

ICD-10 G96 is a billable code used to indicate a diagnosis of other disorders of central nervous system.

Key Diagnostic Point:

The ICD-10 code G96 encompasses a variety of disorders affecting the central nervous system (CNS) that do not fall under more specific categories. This includes pain syndromes such as neuropathic pain, which can arise from nerve damage or dysfunction, leading to chronic pain conditions. Autonomic disorders, which affect involuntary bodily functions, may also be classified under this code, including conditions like dysautonomia that disrupt normal autonomic regulation. Hydrocephalus, characterized by an accumulation of cerebrospinal fluid (CSF) within the ventricles of the brain, can lead to increased intracranial pressure and neurological deficits. Other nervous system disorders may include conditions such as myelopathy or encephalopathy that do not have a more specific classification. Accurate coding requires a thorough understanding of the underlying conditions and their manifestations, as well as the clinical context in which they occur.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of conditions included under the code
  • Need for precise clinical documentation to support coding
  • Potential overlap with other specific codes
  • Variability in symptoms and presentations

Audit Risk Factors

  • Insufficient documentation of the specific disorder
  • Inconsistent coding across different encounters
  • Lack of clarity in the clinical rationale for the diagnosis
  • Failure to document co-existing conditions

Specialty Focus

Medical Specialties

Neurology

Documentation Requirements

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

Common Clinical Scenarios

Patients presenting with chronic pain syndromes, autonomic dysfunction, or hydrocephalus.

Billing Considerations

Ensure that all neurological assessments and diagnostic tests are documented to support the diagnosis.

Neurosurgery

Documentation Requirements

Surgical notes, pre-operative assessments, and post-operative follow-ups.

Common Clinical Scenarios

Patients undergoing procedures for hydrocephalus or other CNS disorders.

Billing Considerations

Document the surgical indications and outcomes clearly to justify the use of G96.

Coding Guidelines

Inclusion Criteria

Use G96 When
  • According to official coding guidelines, G96 should be used when the specific disorder does not have a more precise code
  • Coders must ensure that the documentation supports the diagnosis and that the condition is not better classified under a more specific code

Exclusion Criteria

Do NOT use G96 When
No specific exclusions found.

Related CPT Codes

99214CPT Code

Established patient office visit, level 4

Clinical Scenario

Used for follow-up visits for patients with chronic CNS disorders.

Documentation Requirements

Document the patient's history, examination findings, and treatment plan.

Specialty Considerations

Neurologists should ensure that all neurological assessments are included.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of CNS disorders, improving the granularity of data collection and reimbursement processes. G96 serves as a catch-all for conditions that do not fit neatly into other categories, emphasizing the need for precise documentation.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of CNS disorders, improving the granularity of data collection and reimbursement processes. G96 serves as a catch-all for conditions that do not fit neatly into other categories, emphasizing the need for precise documentation.

Reimbursement & Billing Impact

reimbursement processes. G96 serves as a catch-all for conditions that do not fit neatly into other categories, emphasizing the need for precise documentation.

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 types of conditions are included under G96?

G96 includes a variety of CNS disorders such as pain syndromes, autonomic disorders, hydrocephalus, and other unspecified nervous system disorders.

How do I determine if G96 is the correct code to use?

G96 should be used when the specific disorder does not have a more precise code. Review the clinical documentation to ensure it supports the diagnosis.