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v1.0.0
ICD-10 Guide
ICD-10 CodesChapter 6: Diseases of the nervous systemG36

G36

Billable

Other acute disseminated demyelination

Chapter 6:Diseases of the nervous system

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

Code Description

ICD-10 G36 is a billable code used to indicate a diagnosis of other acute disseminated demyelination.

Key Diagnostic Point:

Other acute disseminated demyelination (G36) refers to a group of neurological disorders characterized by the rapid onset of demyelination in the central nervous system (CNS). This condition can manifest as a result of various infectious, autoimmune, or inflammatory processes. It is often associated with symptoms such as visual disturbances, motor weakness, sensory changes, and cognitive dysfunction. Acute disseminated demyelination is frequently seen in pediatric populations following viral infections, such as varicella or Epstein-Barr virus. Unlike multiple sclerosis (MS), which is a chronic demyelinating disease, G36 represents an acute episode that may resolve completely or lead to residual neurological deficits. The pathophysiology involves an immune-mediated attack on myelin sheaths, leading to impaired nerve conduction. Diagnosis typically requires a combination of clinical evaluation, MRI findings, and cerebrospinal fluid analysis. Treatment may include corticosteroids and other immunomodulatory therapies aimed at reducing inflammation and promoting recovery.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between acute disseminated demyelination and multiple sclerosis.
  • Variability in clinical presentation and symptomatology.
  • Need for comprehensive documentation of neurological assessments.
  • Potential overlap with other demyelinating conditions.

Audit Risk Factors

  • Inadequate documentation of clinical findings.
  • Misdiagnosis due to symptom overlap with other conditions.
  • Failure to document the acute nature of the demyelination.
  • Lack of supporting imaging or laboratory results.

Specialty Focus

Medical Specialties

Neurology

Documentation Requirements

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

Common Clinical Scenarios

Patients presenting with acute neurological deficits following viral infections.

Billing Considerations

Ensure clear documentation of symptom onset and progression to support the acute diagnosis.

Pediatrics

Documentation Requirements

History of recent infections, developmental milestones, and neurological assessments.

Common Clinical Scenarios

Children presenting with sudden onset of neurological symptoms post-infection.

Billing Considerations

Consider age-related factors in symptom presentation and recovery.

Coding Guidelines

Inclusion Criteria

Use G36 When
  • According to ICD
  • 10 guidelines, G36 should be used when the demyelination is acute and not attributable to other specified conditions
  • It is important to document the acute nature and any relevant infectious history

Exclusion Criteria

Do NOT use G36 When
No specific exclusions found.

Related CPT Codes

99214CPT Code

Established patient office visit, level 4

Clinical Scenario

Used for follow-up visits after acute demyelination treatment.

Documentation Requirements

Document history of present illness, examination findings, and treatment response.

Specialty Considerations

Neurologists should ensure detailed 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 demyelinating diseases, improving the accuracy of diagnoses and treatment tracking for conditions like G36. This specificity aids in better patient management and resource allocation.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of demyelinating diseases, improving the accuracy of diagnoses and treatment tracking for conditions like G36. This specificity aids in better patient management and resource allocation.

Reimbursement & Billing Impact

reimbursement.

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 G36 and G35?

G36 refers to acute disseminated demyelination, which is typically a transient condition, while G35 denotes multiple sclerosis, a chronic demyelinating disease.