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ICD-10 Guide
ICD-10 CodesChapter 6: Diseases of the nervous systemG37

G37

Billable

Other demyelinating diseases of central nervous system

Chapter 6:Diseases of the nervous system

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

Code Description

ICD-10 G37 is a billable code used to indicate a diagnosis of other demyelinating diseases of central nervous system.

Key Diagnostic Point:

G37 encompasses a variety of demyelinating diseases affecting the central nervous system (CNS), which includes the brain and spinal cord. These conditions are characterized by the destruction of the myelin sheath, a protective covering that surrounds nerve fibers, leading to impaired nerve signal transmission. Multiple sclerosis (MS) is the most recognized demyelinating disease under this code, presenting with symptoms such as fatigue, motor weakness, sensory disturbances, and cognitive dysfunction. Other conditions classified under G37 may include neuromyelitis optica, acute disseminated encephalomyelitis, and other rare demyelinating disorders. The etiology of these diseases is often multifactorial, involving genetic predisposition, environmental triggers, and autoimmune mechanisms. Immunomodulatory treatments, such as interferons and monoclonal antibodies, are commonly employed to manage symptoms and modify disease progression. Accurate coding for G37 requires a thorough understanding of the specific demyelinating condition being treated, as well as the clinical context and treatment modalities involved.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of conditions under G37 requiring specific documentation.
  • Differentiation from other neurological disorders.
  • Need for detailed clinical history and treatment plans.
  • Potential for overlapping symptoms with other diagnoses.

Audit Risk Factors

  • Inadequate documentation of specific demyelinating condition.
  • Failure to capture all relevant symptoms and treatments.
  • Misclassification of demyelinating diseases.
  • Inconsistent coding across different encounters.

Specialty Focus

Medical Specialties

Neurology

Documentation Requirements

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

Common Clinical Scenarios

Diagnosis of MS, treatment initiation with immunomodulatory therapy, and monitoring of disease progression.

Billing Considerations

Ensure clarity in documenting the specific type of demyelinating disease and any comorbid conditions.

Rehabilitation Medicine

Documentation Requirements

Functional assessments, therapy progress notes, and interdisciplinary care plans.

Common Clinical Scenarios

Rehabilitation following exacerbation of MS or other demyelinating conditions.

Billing Considerations

Document the impact of the condition on functional abilities and the goals of therapy.

Coding Guidelines

Inclusion Criteria

Use G37 When
  • Follow official ICD
  • 10 coding guidelines, ensuring accurate documentation of the specific demyelinating disease
  • Include relevant clinical findings, treatment plans, and any associated conditions

Exclusion Criteria

Do NOT use G37 When
  • Exclude conditions that do not meet the criteria for G37

Related CPT Codes

99214CPT Code

Office visit, established patient, moderate complexity

Clinical Scenario

Used for follow-up visits for patients with demyelinating diseases.

Documentation Requirements

Document history, examination, and medical decision-making.

Specialty Considerations

Neurology specialists 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 data collection and reimbursement processes. G37 provides a broader classification that helps in understanding the epidemiology of these conditions.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of demyelinating diseases, improving the accuracy of data collection and reimbursement processes. G37 provides a broader classification that helps in understanding the epidemiology of these conditions.

Reimbursement & Billing Impact

reimbursement processes. G37 provides a broader classification that helps in understanding the epidemiology of these conditions.

Resources

Clinical References

  • •
    National Multiple Sclerosis Society

Coding & Billing References

  • •
    National Multiple Sclerosis Society

Frequently Asked Questions

What conditions are included under G37?

G37 includes various demyelinating diseases such as multiple sclerosis, neuromyelitis optica, and acute disseminated encephalomyelitis, among others.

How do I differentiate between G37 and G35?

G35 is specifically for multiple sclerosis, while G37 encompasses other demyelinating diseases. Accurate documentation is essential to ensure the correct code is used.