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v1.0.0
ICD-10 Guide
ICD-10 CodesG96.198

G96.198

Billable

Other disorders of meninges, not elsewhere classified

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

Code Description

ICD-10 G96.198 is a billable code used to indicate a diagnosis of other disorders of meninges, not elsewhere classified.

Key Diagnostic Point:

G96.198 encompasses a variety of conditions affecting the meninges, which are the protective membranes covering the brain and spinal cord. These disorders can manifest in various ways, including pain syndromes, autonomic dysfunction, and hydrocephalus. Patients may experience chronic headaches, neck stiffness, or neurological deficits due to inflammation or other pathological changes in the meninges. Autonomic disorders may present with symptoms such as abnormal heart rate, blood pressure fluctuations, or gastrointestinal disturbances, complicating the clinical picture. Hydrocephalus, characterized by an accumulation of cerebrospinal fluid (CSF) within the ventricles, can lead to increased intracranial pressure and requires careful monitoring and management. Other nervous system disorders associated with meninges may include infections, tumors, or post-surgical complications. Accurate diagnosis often necessitates imaging studies, lumbar punctures, and comprehensive neurological evaluations to determine the underlying cause and appropriate treatment.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of potential underlying conditions
  • Overlap with other neurological disorders
  • Need for detailed clinical documentation
  • Potential for misclassification with similar codes

Audit Risk Factors

  • Inadequate documentation of symptoms
  • Failure to specify the underlying cause
  • Misuse of related codes
  • Lack of supporting diagnostic tests

Specialty Focus

Medical Specialties

Neurology

Documentation Requirements

Comprehensive neurological examination findings, imaging results, and laboratory tests.

Common Clinical Scenarios

Patients presenting with chronic headaches, signs of increased intracranial pressure, or neurological deficits.

Billing Considerations

Ensure detailed documentation of symptoms and diagnostic tests to support the use of G96.198.

Neurosurgery

Documentation Requirements

Operative reports, post-operative assessments, and follow-up evaluations.

Common Clinical Scenarios

Post-surgical patients experiencing complications related to meninges, such as infection or CSF leaks.

Billing Considerations

Document any surgical interventions and their outcomes to justify the use of this code.

Coding Guidelines

Inclusion Criteria

Use G96.198 When
  • According to ICD
  • 10 coding guidelines, G96
  • 198 should be used when the specific disorder of the meninges is not classified elsewhere
  • Coders must ensure that the documentation supports the diagnosis and that other more specific codes are not applicable

Exclusion Criteria

Do NOT use G96.198 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

62270CPT Code

Lumbar puncture

Clinical Scenario

Used to obtain cerebrospinal fluid for analysis in suspected meningeal disorders.

Documentation Requirements

Document indication for the procedure, findings, and any complications.

Specialty Considerations

Neurologists and neurosurgeons should ensure that the rationale for the lumbar puncture is clearly documented.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of neurological disorders, including G96.198. This specificity aids in better tracking of conditions and outcomes, but also requires coders to be more diligent in documentation and coding practices.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of neurological disorders, including G96.198. This specificity aids in better tracking of conditions and outcomes, but also requires coders to be more diligent in documentation and coding practices.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of neurological disorders, including G96.198. This specificity aids in better tracking of conditions and outcomes, but also requires coders to be more diligent in documentation and coding practices.

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 G96.198?

G96.198 includes various unspecified disorders of the meninges, such as those resulting from inflammation, infection, or structural abnormalities, but does not include specific conditions like meningitis.