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v1.0.0
ICD-10 Guide
ICD-10 CodesChapter 6: Diseases of the nervous systemG07

G07

Billable

Intracranial and intraspinal abscess and granuloma in diseases classified elsewhere

Chapter 6:Diseases of the nervous system

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

Code Description

ICD-10 G07 is a billable code used to indicate a diagnosis of intracranial and intraspinal abscess and granuloma in diseases classified elsewhere.

Key Diagnostic Point:

G07 is used to classify intracranial and intraspinal abscesses and granulomas that arise as complications of diseases classified in other chapters of the ICD-10. These conditions often result from infections, such as bacterial, viral, or fungal pathogens, and can lead to significant morbidity if not diagnosed and treated promptly. Intracranial abscesses may occur due to direct extension from adjacent infections, such as sinusitis or otitis media, or as a result of hematogenous spread from distant sites. Intraspinal abscesses can occur in the context of spinal infections or as a complication of systemic diseases. Clinical manifestations may include fever, headache, neurological deficits, and signs of increased intracranial pressure. Diagnosis typically involves imaging studies such as MRI or CT scans, and management may require surgical intervention, antibiotics, or both. Accurate coding is essential for proper reimbursement and to reflect the complexity of the patient's condition.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Requires understanding of underlying diseases causing abscesses
  • Differentiation between abscess and granuloma
  • Need for precise documentation of the primary disease
  • Potential for multiple coding scenarios based on clinical presentation

Audit Risk Factors

  • Inadequate documentation of the primary disease
  • Failure to specify the location of the abscess or granuloma
  • Misclassification of abscess versus other types of lesions
  • Inconsistent coding of associated symptoms

Specialty Focus

Medical Specialties

Neurology

Documentation Requirements

Detailed history of neurological symptoms, imaging results, and treatment plans.

Common Clinical Scenarios

Patients presenting with headaches, fever, and neurological deficits.

Billing Considerations

Ensure that the primary disease leading to the abscess is clearly documented.

Infectious Disease

Documentation Requirements

Comprehensive documentation of infectious etiology, laboratory results, and response to treatment.

Common Clinical Scenarios

Patients with systemic infections leading to CNS complications.

Billing Considerations

Document the infectious source and any relevant travel history or exposure risks.

Coding Guidelines

Inclusion Criteria

Use G07 When
  • According to ICD
  • 10 guidelines, G07 should be used when the abscess or granuloma is a direct complication of a disease classified elsewhere
  • Coders must ensure that the primary disease is coded first, followed by G07 to indicate the complication

Exclusion Criteria

Do NOT use G07 When
No specific exclusions found.

Related CPT Codes

62270CPT Code

Aspiration of intracranial abscess

Clinical Scenario

Used when a patient with G07 requires drainage of an abscess.

Documentation Requirements

Document the indication for aspiration, imaging findings, and patient consent.

Specialty Considerations

Neurosurgery may be involved in the procedure.

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 G07, improving the granularity of data for research and reimbursement. It has also necessitated more detailed documentation from healthcare providers.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of conditions like G07, improving the granularity of data for research and reimbursement. It has also necessitated more detailed documentation from healthcare providers.

Reimbursement & Billing Impact

reimbursement. It has also necessitated more detailed documentation from healthcare providers.

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

When should G07 be used?

G07 should be used when documenting an intracranial or intraspinal abscess or granuloma that is a complication of a disease classified elsewhere in the ICD-10.

What documentation is needed for G07?

Documentation must include the primary disease causing the abscess, imaging results, and any relevant clinical symptoms or treatment plans.