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v1.0.0
ICD-10 Guide
ICD-10 CodesG96.12

G96.12

Billable

Meningeal adhesions (cerebral) (spinal)

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

Code Description

ICD-10 G96.12 is a billable code used to indicate a diagnosis of meningeal adhesions (cerebral) (spinal).

Key Diagnostic Point:

Meningeal adhesions refer to fibrous bands that form between the layers of the meninges, which are the protective membranes covering the brain and spinal cord. These adhesions can occur due to various factors, including previous surgeries, infections, or inflammatory conditions. Clinically, patients may present with a range of symptoms, including chronic pain syndromes, which can manifest as headaches or back pain, depending on the location of the adhesions. Autonomic disorders may arise due to the disruption of normal neural pathways, leading to symptoms such as changes in heart rate, blood pressure, and gastrointestinal function. Hydrocephalus, characterized by an accumulation of cerebrospinal fluid (CSF) in the ventricles of the brain, can also occur if the adhesions obstruct CSF flow. Other nervous system disorders may include neurological deficits or exacerbation of pre-existing conditions. Diagnosis typically involves imaging studies such as MRI or CT scans, and treatment may require surgical intervention to release the adhesions.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in clinical presentation and symptoms
  • Need for detailed documentation of prior medical history
  • Potential for overlapping symptoms with other neurological conditions
  • Requirement for imaging studies to confirm diagnosis

Audit Risk Factors

  • Inadequate documentation of symptoms and history
  • Failure to link the diagnosis to specific treatment provided
  • Misinterpretation of imaging results
  • Coding without sufficient clinical evidence

Specialty Focus

Medical Specialties

Neurology

Documentation Requirements

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

Common Clinical Scenarios

Patients presenting with chronic headaches, back pain, or neurological deficits.

Billing Considerations

Ensure clear documentation of the relationship between symptoms and meningeal adhesions.

Neurosurgery

Documentation Requirements

Operative reports detailing the surgical approach and findings related to adhesions.

Common Clinical Scenarios

Patients undergoing surgery for decompression or adhesion release.

Billing Considerations

Document the rationale for surgical intervention and expected outcomes.

Coding Guidelines

Inclusion Criteria

Use G96.12 When
  • Follow official ICD
  • 10 coding guidelines, ensuring accurate documentation of the condition's etiology and any associated symptoms
  • Include relevant imaging studies and treatment plans in the documentation

Exclusion Criteria

Do NOT use G96.12 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

62263CPT Code

Laminectomy, facetectomy, and/or foraminotomy

Clinical Scenario

Used in cases where adhesions are surgically released.

Documentation Requirements

Operative report detailing the procedure and findings.

Specialty Considerations

Neurosurgeons should document the extent of adhesions and any complications.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of conditions like meningeal adhesions, improving the accuracy of data collection and reimbursement processes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of conditions like meningeal adhesions, improving the accuracy of data collection and reimbursement processes.

Reimbursement & Billing Impact

reimbursement processes.

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 are meningeal adhesions?

Meningeal adhesions are fibrous bands that form between the layers of the meninges, often due to previous surgeries, infections, or inflammation, leading to various neurological symptoms.

How are meningeal adhesions diagnosed?

Diagnosis typically involves imaging studies such as MRI or CT scans, along with a thorough clinical evaluation of symptoms.

What treatments are available for meningeal adhesions?

Treatment may include pain management, physical therapy, or surgical intervention to release the adhesions, depending on the severity of symptoms.