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v1.0.0
ICD-10 Guide
ICD-10 CodesG97.1

G97.1

Billable

Other reaction to spinal and lumbar puncture

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

Code Description

ICD-10 G97.1 is a billable code used to indicate a diagnosis of other reaction to spinal and lumbar puncture.

Key Diagnostic Point:

G97.1 refers to various reactions that may occur following a spinal or lumbar puncture, which is a procedure used to collect cerebrospinal fluid (CSF) or administer medications. Common reactions include post-puncture headache, pain syndromes, and autonomic disorders. Patients may experience headaches due to CSF leakage, which can lead to intracranial hypotension. Pain syndromes may manifest as localized pain at the puncture site or radiating pain due to nerve irritation. Autonomic disorders can arise, affecting heart rate and blood pressure regulation. In some cases, hydrocephalus may develop if CSF flow is obstructed or altered. Other nervous system disorders may also be exacerbated by the procedure, necessitating careful monitoring and management. Accurate coding of G97.1 is essential for proper patient care and reimbursement, as it reflects the complications that can arise from spinal interventions.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in patient reactions to the procedure
  • Differentiation between normal and abnormal reactions
  • Need for detailed documentation of symptoms
  • Potential overlap with other neurological conditions

Audit Risk Factors

  • Inadequate documentation of symptoms and reactions
  • Misclassification of reactions as complications
  • Failure to link diagnosis with procedure appropriately
  • Inconsistent coding practices across providers

Specialty Focus

Medical Specialties

Neurology

Documentation Requirements

Detailed accounts of patient symptoms post-procedure, including onset, duration, and severity.

Common Clinical Scenarios

Patients presenting with headaches or neurological deficits following lumbar puncture.

Billing Considerations

Consideration of pre-existing conditions that may influence patient reactions.

Anesthesiology

Documentation Requirements

Records of the procedure, including technique, patient response, and any immediate complications.

Common Clinical Scenarios

Patients undergoing spinal anesthesia who develop post-puncture complications.

Billing Considerations

Documentation of patient consent and pre-procedure assessments.

Coding Guidelines

Inclusion Criteria

Use G97.1 When
  • According to ICD
  • 10 guidelines, G97
  • 1 should be used when a patient experiences reactions to spinal or lumbar puncture that do not fit into more specific categories
  • It is important to document the nature of the reaction and any related symptoms

Exclusion Criteria

Do NOT use G97.1 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

62270CPT Code

Lumbar puncture, diagnostic

Clinical Scenario

When a lumbar puncture is performed and the patient later presents with complications.

Documentation Requirements

Document the indication for the procedure and any complications that arise.

Specialty Considerations

Anesthesiologists should document the technique used and any immediate patient responses.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of complications related to spinal procedures, improving the accuracy of patient records and reimbursement processes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of complications related to spinal procedures, improving the accuracy of patient records and reimbursement processes.

Reimbursement & Billing Impact

reimbursement processes.

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 symptoms warrant the use of G97.1?

Symptoms such as severe headaches, autonomic instability, or pain at the puncture site following a spinal or lumbar puncture may warrant the use of G97.1.