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v1.0.0
ICD-10 Guide
ICD-10 CodesG96.19

G96.19

Billable

Other disorders of meninges, not elsewhere classified

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

Code Description

ICD-10 G96.19 is a billable code used to indicate a diagnosis of other disorders of meninges, not elsewhere classified.

Key Diagnostic Point:

G96.19 encompasses a variety of conditions affecting the meninges, the protective membranes covering the brain and spinal cord. These disorders can manifest through various symptoms, including pain syndromes, autonomic dysfunction, and hydrocephalus. Pain syndromes may arise from inflammation or irritation of the meninges, leading to headaches or neck pain. Autonomic disorders can occur due to disruption in the autonomic nervous system, which may result in symptoms such as abnormal heart rate, blood pressure fluctuations, or gastrointestinal disturbances. Hydrocephalus, characterized by an accumulation of cerebrospinal fluid (CSF) within the ventricles of the brain, can lead to increased intracranial pressure and neurological deficits. Other nervous system disorders may also be classified under this code, particularly when they do not fit neatly into other specific categories. Accurate diagnosis and documentation are crucial, as these conditions can significantly impact patient management and treatment outcomes.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of symptoms and presentations
  • Overlap with other neurological conditions
  • Need for comprehensive documentation
  • Potential for misclassification

Audit Risk Factors

  • Inadequate documentation of symptoms
  • Failure to specify the underlying cause
  • Misuse of related codes
  • Inconsistent coding practices across providers

Specialty Focus

Medical Specialties

Neurology

Documentation Requirements

Detailed clinical notes outlining symptoms, diagnostic tests, and treatment plans.

Common Clinical Scenarios

Patients presenting with headaches, autonomic dysfunction, or signs of increased intracranial pressure.

Billing Considerations

Ensure that all relevant diagnostic tests (e.g., MRI, lumbar puncture) are documented to support the diagnosis.

Neurosurgery

Documentation Requirements

Operative reports, pre-operative assessments, and post-operative follow-ups must be comprehensive.

Common Clinical Scenarios

Surgical interventions for hydrocephalus or other meningeal disorders.

Billing Considerations

Document the rationale for surgical intervention and any complications that arise.

Coding Guidelines

Inclusion Criteria

Use G96.19 When
  • According to ICD
  • 10 guidelines, G96
  • 19 should be used when a specific disorder of the meninges is not classified elsewhere
  • Coders must ensure that the diagnosis is supported by clinical documentation and that other more specific codes are not applicable

Exclusion Criteria

Do NOT use G96.19 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

62270CPT Code

Lumbar puncture

Clinical Scenario

Used to diagnose conditions related to meningeal disorders.

Documentation Requirements

Document indication for the procedure and findings.

Specialty Considerations

Neurology must ensure that the procedure is justified based on clinical symptoms.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of meningeal disorders, improving the accuracy of diagnoses and treatment tracking. G96.19 serves as a catch-all for conditions that do not fit neatly into other categories, emphasizing the need for precise documentation.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of meningeal disorders, improving the accuracy of diagnoses and treatment tracking. G96.19 serves as a catch-all for conditions that do not fit neatly into other categories, emphasizing the need for precise documentation.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of meningeal disorders, improving the accuracy of diagnoses and treatment tracking. G96.19 serves as a catch-all for conditions that do not fit neatly into other categories, emphasizing the need for precise documentation.

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 conditions are included under G96.19?

G96.19 includes various unspecified disorders of the meninges, such as pain syndromes, autonomic dysfunction, and hydrocephalus, among others.