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ICD-10 Guide
ICD-10 CodesChapter 6: Diseases of the nervous systemG94

G94

Billable

Other disorders of brain 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 G94 is a billable code used to indicate a diagnosis of other disorders of brain in diseases classified elsewhere.

Key Diagnostic Point:

The ICD-10 code G94 encompasses a variety of brain disorders that are secondary to other diseases classified in different categories. This includes conditions such as pain syndromes, autonomic disorders, and hydrocephalus, which may arise due to underlying systemic diseases or neurological conditions. Pain syndromes can manifest as chronic headaches or neuropathic pain, often complicating the clinical picture. Autonomic disorders may present with dysregulation of bodily functions, such as blood pressure fluctuations or gastrointestinal disturbances, which can be traced back to brain dysfunction. Hydrocephalus, characterized by an accumulation of cerebrospinal fluid (CSF) in the brain's ventricles, can lead to increased intracranial pressure and neurological deficits. Other nervous system disorders may include encephalopathy or cognitive impairments that are secondary to systemic illnesses like infections, metabolic disorders, or toxic exposures. Accurate coding of G94 requires a thorough understanding of the primary condition and its relationship to the brain disorder, as well as comprehensive documentation to support the diagnosis.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of underlying conditions leading to brain disorders
  • Need for precise documentation linking primary disease to brain disorder
  • Differentiation from other neurological codes
  • Potential for overlapping symptoms with other diagnoses

Audit Risk Factors

  • Inadequate documentation linking primary disease to brain disorder
  • Misinterpretation of symptoms leading to incorrect coding
  • Failure to capture all relevant diagnoses
  • Inconsistent use of terminology in clinical notes

Specialty Focus

Medical Specialties

Neurology

Documentation Requirements

Detailed clinical notes outlining the relationship between the primary disease and brain disorder, including diagnostic tests and treatment plans.

Common Clinical Scenarios

Patients with chronic pain syndromes secondary to neurological conditions, autonomic dysfunction due to systemic diseases, or hydrocephalus resulting from infections.

Billing Considerations

Ensure that all relevant diagnostic tests are documented, and the clinical rationale for the diagnosis is clear.

Internal Medicine

Documentation Requirements

Comprehensive documentation of the patient's medical history, including any systemic diseases that may affect brain function.

Common Clinical Scenarios

Patients with diabetes presenting with neuropathic pain or autonomic dysfunction.

Billing Considerations

Highlight the interplay between systemic diseases and neurological symptoms to support accurate coding.

Coding Guidelines

Inclusion Criteria

Use G94 When
  • According to ICD
  • 10 coding guidelines, G94 should be used when the brain disorder is a direct consequence of a disease classified elsewhere
  • Coders must ensure that the primary condition is clearly documented and that the brain disorder is appropriately linked to it

Exclusion Criteria

Do NOT use G94 When
No specific exclusions found.

Related CPT Codes

99214CPT Code

Established patient office visit, level 4

Clinical Scenario

Used for follow-up visits for patients with chronic brain disorders.

Documentation Requirements

Detailed history and examination notes, including updates on symptoms and treatment response.

Specialty Considerations

Neurologists should document neurological examinations thoroughly to support the complexity of the visit.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of brain disorders, improving the ability to capture the complexity of conditions like those classified under G94. 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 brain disorders, improving the ability to capture the complexity of conditions like those classified under G94. 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 brain disorders, improving the ability to capture the complexity of conditions like those classified under G94. 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

When should I use G94 instead of a more specific code?

G94 should be used when the brain disorder is a direct consequence of a disease classified elsewhere and no more specific code is available to describe the condition.