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v1.0.0
ICD-10 Guide
ICD-10 CodesG06.0

G06.0

Billable

Intracranial abscess and granuloma

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

Code Description

ICD-10 G06.0 is a billable code used to indicate a diagnosis of intracranial abscess and granuloma.

Key Diagnostic Point:

Intracranial abscesses and granulomas are localized collections of pus or inflammatory tissue within the cranial cavity, often resulting from infections, trauma, or other pathological processes. These conditions can arise from various sources, including bacterial, viral, or fungal infections, and may be associated with other central nervous system (CNS) infections such as meningitis or encephalitis. Symptoms may include headache, fever, neurological deficits, and altered mental status, depending on the abscess's location and size. Diagnosis typically involves imaging studies such as CT or MRI scans, which can reveal the presence of an abscess or granuloma. Treatment often requires a combination of antibiotics and surgical intervention to drain the abscess, especially if it is large or causing significant pressure on surrounding brain structures. The prognosis varies based on the underlying cause, the patient's overall health, and the timeliness of treatment.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between abscess and granuloma based on imaging and clinical presentation.
  • Identifying the underlying cause of the abscess (e.g., bacterial, fungal, or post-surgical).
  • Documenting associated CNS infections such as meningitis or encephalitis.
  • Understanding the need for surgical intervention versus conservative management.

Audit Risk Factors

  • Inadequate documentation of the abscess's size and location.
  • Failure to document the causative organism or underlying condition.
  • Lack of clarity regarding the treatment plan and follow-up.
  • Misclassification of abscess versus granuloma.

Specialty Focus

Medical Specialties

Neurology

Documentation Requirements

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

Common Clinical Scenarios

Patients presenting with headaches, fever, and neurological deficits requiring imaging.

Billing Considerations

Neurologists must ensure comprehensive documentation of neurological assessments and any changes in the patient's condition.

Neurosurgery

Documentation Requirements

Surgical notes, imaging studies, and post-operative care documentation.

Common Clinical Scenarios

Patients requiring surgical drainage of an abscess or granuloma.

Billing Considerations

Neurosurgeons should document the surgical approach, findings, and any complications encountered during the procedure.

Coding Guidelines

Inclusion Criteria

Use G06.0 When
  • According to ICD
  • 10 coding guidelines, G06
  • 0 should be used when there is clear documentation of an intracranial abscess or granuloma
  • Coders must ensure that the diagnosis is supported by imaging studies and clinical findings

Exclusion Criteria

Do NOT use G06.0 When
  • Exclusion criteria include conditions that do not involve an abscess or granuloma

Related ICD-10 Codes

Related CPT Codes

61550CPT Code

Craniotomy for abscess drainage

Clinical Scenario

Used when surgical intervention is required for an intracranial abscess.

Documentation Requirements

Operative report detailing the procedure, findings, and any complications.

Specialty Considerations

Neurosurgeons must ensure accurate coding of the procedure in relation to the diagnosis.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of intracranial abscesses and granulomas, improving the accuracy of data collection and reimbursement processes. This specificity aids in better tracking of epidemiological trends and treatment outcomes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of intracranial abscesses and granulomas, improving the accuracy of data collection and reimbursement processes. This specificity aids in better tracking of epidemiological trends and treatment outcomes.

Reimbursement & Billing Impact

reimbursement processes. This specificity aids in better tracking of epidemiological trends and treatment outcomes.

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 is the difference between an abscess and a granuloma?

An abscess is a localized collection of pus due to infection, while a granuloma is a small area of inflammation that can occur in response to infection or foreign substances. Both can occur in the brain but have different underlying causes and treatment approaches.