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ICD-10 Guide
ICD-10 CodesG91.1

G91.1

Billable

Obstructive hydrocephalus

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

Code Description

ICD-10 G91.1 is a billable code used to indicate a diagnosis of obstructive hydrocephalus.

Key Diagnostic Point:

Obstructive hydrocephalus is a condition characterized by an accumulation of cerebrospinal fluid (CSF) within the ventricles of the brain due to a blockage in the normal flow of CSF. This obstruction can occur at various points along the CSF pathway, such as the aqueduct of Sylvius or the foramina of Monro. The increased pressure from the accumulated fluid can lead to a range of neurological symptoms, including headaches, nausea, vomiting, cognitive dysfunction, and visual disturbances. In infants, signs may include an enlarged head circumference, irritability, and developmental delays. The condition can be caused by congenital malformations, tumors, infections, or traumatic injuries. Diagnosis typically involves neuroimaging techniques such as MRI or CT scans to visualize the ventricles and identify the site of obstruction. Treatment often requires surgical intervention, such as the placement of a shunt to divert CSF and relieve pressure on the brain. Long-term management may involve monitoring for complications and addressing any underlying causes of the obstruction.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of underlying causes (congenital, acquired)
  • Need for precise documentation of symptoms and imaging results
  • Potential for co-existing conditions affecting coding
  • Variability in treatment approaches and follow-up care

Audit Risk Factors

  • Inadequate documentation of the cause of obstruction
  • Failure to document associated symptoms
  • Incorrect coding of co-existing conditions
  • Lack of follow-up documentation post-surgery

Specialty Focus

Medical Specialties

Neurology

Documentation Requirements

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

Common Clinical Scenarios

Patients presenting with headaches, cognitive changes, or developmental delays in children.

Billing Considerations

Ensure all imaging studies are documented and correlate with clinical findings.

Neurosurgery

Documentation Requirements

Surgical notes, post-operative care plans, and follow-up assessments.

Common Clinical Scenarios

Patients undergoing shunt placement or other surgical interventions for hydrocephalus.

Billing Considerations

Document the indication for surgery and any complications that arise.

Coding Guidelines

Inclusion Criteria

Use G91.1 When
  • According to ICD
  • 10 guidelines, G91
  • 1 should be used when there is clear documentation of obstructive hydrocephalus
  • It is important to include the cause of obstruction and any associated symptoms
  • obstructive hydrocephalus and other types of hydrocephalus that do not involve obstruction

Exclusion Criteria

Do NOT use G91.1 When
  • Exclusion criteria include non

Related ICD-10 Codes

Related CPT Codes

62230CPT Code

Insertion of ventricular shunt

Clinical Scenario

Used for patients diagnosed with obstructive hydrocephalus requiring surgical intervention.

Documentation Requirements

Surgical notes detailing the procedure and indication for shunt placement.

Specialty Considerations

Neurosurgeons must document the specific type of shunt and any complications.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of obstructive hydrocephalus, improving the accuracy of diagnosis and treatment tracking. 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 obstructive hydrocephalus, improving the accuracy of diagnosis and treatment tracking. This specificity aids in better patient management and resource allocation.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of obstructive hydrocephalus, improving the accuracy of diagnosis and treatment tracking. This specificity aids in better patient management and resource allocation.

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 are the common causes of obstructive hydrocephalus?

Common causes include congenital malformations, tumors, infections, and traumatic injuries that block the flow of cerebrospinal fluid.

How is obstructive hydrocephalus diagnosed?

Diagnosis is typically made through neuroimaging techniques such as MRI or CT scans, which reveal ventricular enlargement and the site of obstruction.