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v1.0.0
ICD-10 Guide
ICD-10 CodesG95.11

G95.11

Billable

Acute infarction of spinal cord (embolic) (nonembolic)

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

Code Description

ICD-10 G95.11 is a billable code used to indicate a diagnosis of acute infarction of spinal cord (embolic) (nonembolic).

Key Diagnostic Point:

Acute infarction of the spinal cord, classified under G95.11, refers to the sudden loss of blood supply to the spinal cord, leading to tissue death. This condition can arise from both embolic and nonembolic causes. Embolic infarctions occur when a blood clot or debris travels from another part of the body and lodges in the spinal arteries, while nonembolic infarctions may result from direct trauma, vascular compromise, or systemic conditions affecting blood flow. Clinically, patients may present with acute onset of motor and sensory deficits, pain syndromes, and autonomic dysfunction. Pain can manifest as radicular pain, which is sharp and follows the nerve root distribution, or as central pain syndrome, characterized by a burning sensation. Autonomic disorders may include bladder dysfunction, bowel incontinence, and changes in blood pressure regulation. Hydrocephalus can also develop due to obstruction of cerebrospinal fluid pathways, leading to increased intracranial pressure. The prognosis varies based on the extent of the infarction and the timeliness of medical intervention.

Code Complexity Analysis

Complexity Rating: High

High Complexity

Complexity Factors

  • Differentiating between embolic and nonembolic causes
  • Need for detailed clinical documentation to support diagnosis
  • Potential for overlapping symptoms with other neurological disorders
  • Variability in presentation and severity among patients

Audit Risk Factors

  • Inadequate documentation of the cause of infarction
  • Failure to document associated symptoms and complications
  • Misclassification of the type of infarction
  • Lack of clarity in the clinical rationale for the diagnosis

Specialty Focus

Medical Specialties

Neurology

Documentation Requirements

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

Common Clinical Scenarios

Patients presenting with sudden onset of weakness, sensory loss, or bowel/bladder dysfunction.

Billing Considerations

Ensure clear documentation of the infarction type and associated symptoms to support coding.

Emergency Medicine

Documentation Requirements

Initial assessment, imaging studies, and immediate interventions performed.

Common Clinical Scenarios

Patients with acute back pain and neurological deficits requiring urgent evaluation.

Billing Considerations

Document the time of onset of symptoms and any interventions performed to establish urgency.

Coding Guidelines

Inclusion Criteria

Use G95.11 When
  • Follow official coding guidelines for neurological conditions, ensuring accurate documentation of the cause of the infarction
  • Include details about the patient's clinical presentation, imaging findings, and any treatments administered

Exclusion Criteria

Do NOT use G95.11 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

62263CPT Code

Lumbar puncture

Clinical Scenario

Used to assess cerebrospinal fluid in cases of suspected spinal cord infarction.

Documentation Requirements

Document the indication for the procedure and findings.

Specialty Considerations

Neurology specialists should ensure proper indication and follow-up.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for greater specificity in coding conditions like acute spinal cord infarction, enabling better tracking of outcomes and resource allocation.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for greater specificity in coding conditions like acute spinal cord infarction, enabling better tracking of outcomes and resource allocation.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for greater specificity in coding conditions like acute spinal cord infarction, enabling better tracking of outcomes 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 is the difference between embolic and nonembolic spinal cord infarction?

Embolic spinal cord infarction occurs when a blood clot travels from another part of the body and blocks blood flow to the spinal cord, while nonembolic infarction results from direct trauma or vascular issues affecting blood supply.