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ICD-10 Guide
ICD-10 CodesG13.1

G13.1

Billable

Other systemic atrophy primarily affecting central nervous system in neoplastic disease

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

Code Description

ICD-10 G13.1 is a billable code used to indicate a diagnosis of other systemic atrophy primarily affecting central nervous system in neoplastic disease.

Key Diagnostic Point:

G13.1 refers to systemic atrophy of the central nervous system that occurs in the context of neoplastic diseases. This condition can manifest as a result of primary or metastatic tumors affecting the brain and spinal cord, leading to neurodegeneration. The atrophy may be due to direct tumor invasion, pressure effects, or secondary to treatment modalities such as chemotherapy or radiation therapy. Patients may present with a variety of neurological symptoms, including cognitive decline, motor dysfunction, and sensory disturbances. The condition is often associated with other systemic effects of cancer, such as cachexia, which can further complicate the clinical picture. Accurate diagnosis requires a thorough neurological examination, imaging studies, and sometimes biopsy to determine the underlying neoplastic process. Understanding the interplay between the neoplasm and the resultant neurological atrophy is crucial for effective management and coding.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between primary and secondary causes of atrophy
  • Understanding the relationship between neoplastic disease and neurological symptoms
  • Need for comprehensive documentation of neurological assessments
  • Potential overlap with other neurological conditions

Audit Risk Factors

  • Inadequate documentation of the neoplastic disease
  • Failure to specify the type of systemic atrophy
  • Misclassification of symptoms as unrelated to neoplasm
  • Lack of clear linkage between diagnosis and treatment

Specialty Focus

Medical Specialties

Neurology

Documentation Requirements

Detailed neurological assessments, imaging results, and treatment history.

Common Clinical Scenarios

Patients with brain tumors presenting with cognitive decline or motor deficits.

Billing Considerations

Ensure clear documentation of neurological findings and their relation to the neoplastic disease.

Oncology

Documentation Requirements

Comprehensive cancer staging, treatment plans, and side effects of therapies.

Common Clinical Scenarios

Patients undergoing treatment for cancer who develop neurological symptoms.

Billing Considerations

Document the impact of cancer treatment on neurological function.

Coding Guidelines

Inclusion Criteria

Use G13.1 When
  • According to ICD
  • 10 guidelines, G13
  • 1 should be used when systemic atrophy is primarily affecting the central nervous system due to a neoplastic disease
  • Coders must ensure that the underlying neoplasm is documented and that the atrophy is directly linked to it

Exclusion Criteria

Do NOT use G13.1 When
  • Exclusion criteria include atrophy not related to neoplastic processes

Related ICD-10 Codes

Related CPT Codes

99214CPT Code

Established patient office visit, level 4

Clinical Scenario

Used for follow-up visits of patients with G13.1 for neurological assessments.

Documentation Requirements

Document the patient's neurological status, treatment history, and any new symptoms.

Specialty Considerations

Neurologists should ensure comprehensive evaluations are documented.

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 G13.1, enabling better tracking of systemic atrophy related to neoplastic diseases. This specificity aids in research and treatment planning, although it requires coders to have a deeper understanding of the relationships between cancer and neurological symptoms.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of conditions like G13.1, enabling better tracking of systemic atrophy related to neoplastic diseases. This specificity aids in research and treatment planning, although it requires coders to have a deeper understanding of the relationships between cancer and neurological symptoms.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of conditions like G13.1, enabling better tracking of systemic atrophy related to neoplastic diseases. This specificity aids in research and treatment planning, although it requires coders to have a deeper understanding of the relationships between cancer and neurological symptoms.

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 significance of coding G13.1 accurately?

Accurate coding of G13.1 is crucial for proper reimbursement, tracking of disease prevalence, and ensuring that patients receive appropriate care based on their neurological status related to neoplastic diseases.