RE: Help with diagnosis - Spinal AVM
I meant to attach the CC below to previous email. Hope this helps -
Spinal arteriovenous malformation w/resection and monitoring
Coding Clinic, Third Quarter 1995 Page: 5 to 6 Effective with discharges: July 15, 1995
Question:
What are the appropriate ICD-9-CM diagnostic and procedure codes for spinal arteriovenous malformation (AVM) with resection of the spinal AVM and intraoperative somatosensory evoked potential monitoring? The Alphabetic Index (Volume 3) under excision, lesion, blood vessel, does not provide an entry for spinal cord. Should the resection be assigned to code 03.4, Excision or destruction of lesion of spinal cord, or code 38.6X, Other excision of vessels?
Answer:
Assign code 747.82, Spinal vessel anomaly, as the principal diagnosis. Assign procedure code 03.4, Excision or destruction of lesion of spinal cord, for the resection of the AV lesion. It is the location of the tumor in the spinal cord and not the component (blood vessel) that determines the appropriate code to assign for this procedure. Code 89.15, Other nonoperative neurologic function tests, may be assigned for the intraoperative somatosensory evoked potential monitoring.
Arteriovenous malformations are abnormal communications between an artery and a vein that may be congenital or acquired. Congenital AVMs are the result of persistent embryonic vessels that fail to differentiate into arteries and veins and are located in almost every organ of the body. Acquired arteriovenous fistulas are created to provide vascular access for hemodialysis or develop because of a penetrating injury, a complication of arterial catheterization or surgical dissection.
Spinal dural arteriovenous malformations are the most common type of AVMs involving the spinal cord in adults. These lesions cause progressive sensory motor symptoms ranging from painful paraparesis to acute quadriplegia. AVMs are typically fed by radial dural arteries and are found in the dura adjacent to the dorsal nerve root (intervertebral foramen). The preferred treatment is direct obliteration of these lesions by either surgical resection or laser photocoagulation.
Sharon Salinas, CCS
Health Information Management
Barlow Respiratory Hospital
2000 Stadium Way, Los Angeles CA 90026
Tel: 213-250-4200 ext 3336
FAX: 213-202-6490
ssalinas@barlow2000.org
From: CDI Talk [mailto:cdi_talk@hcprotalk.com]
Sent: Wednesday, March 25, 2015 6:26 AM
To: Salinas, Sharon
Subject: [cdi_talk] Help with diagnosis
Has anyone had an opportunity to code an arteriovenous malformation of the thoracolumbar junction ?
This is a new diagnosis for us.
Thank you
Lisa Romanello, RN,BSN,FNS,CCDS
Manager, Clinical Documentation Improvement
Quality and Compliance
CJW Medical Center
Office phone: 804-228-6527
Cell phone: 804-629-0396
AHIMA Approved ICD-10 CM/PCS Trainer
Angelisa.Romanello@HCAHealthcare.com
---
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You are receiving this message as a member of CDI Talk as: ssalinas@barlow2000.org
If you would like to be removed from CDI Talk, please send a blank email to
leave-cdi_talk-12538092.1a48df689a710d0d4e067dc4c85563ef@hcprotalk.com
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Copyright 2013
HCPro, Inc., 75 Sylvan Street, Danvers MA 01923
Confidentiality Notice: This e-mail message, including any attachments, is for the sole use of the intended recipient(s) and may contain confidential and privileged information. Any unauthorized review, use, disclosure or distribution is prohibited. If you are not the intended recipient, please contact the sender by reply e-mail and destroy all copies of the original message.
Spinal arteriovenous malformation w/resection and monitoring
Coding Clinic, Third Quarter 1995 Page: 5 to 6 Effective with discharges: July 15, 1995
Question:
What are the appropriate ICD-9-CM diagnostic and procedure codes for spinal arteriovenous malformation (AVM) with resection of the spinal AVM and intraoperative somatosensory evoked potential monitoring? The Alphabetic Index (Volume 3) under excision, lesion, blood vessel, does not provide an entry for spinal cord. Should the resection be assigned to code 03.4, Excision or destruction of lesion of spinal cord, or code 38.6X, Other excision of vessels?
Answer:
Assign code 747.82, Spinal vessel anomaly, as the principal diagnosis. Assign procedure code 03.4, Excision or destruction of lesion of spinal cord, for the resection of the AV lesion. It is the location of the tumor in the spinal cord and not the component (blood vessel) that determines the appropriate code to assign for this procedure. Code 89.15, Other nonoperative neurologic function tests, may be assigned for the intraoperative somatosensory evoked potential monitoring.
Arteriovenous malformations are abnormal communications between an artery and a vein that may be congenital or acquired. Congenital AVMs are the result of persistent embryonic vessels that fail to differentiate into arteries and veins and are located in almost every organ of the body. Acquired arteriovenous fistulas are created to provide vascular access for hemodialysis or develop because of a penetrating injury, a complication of arterial catheterization or surgical dissection.
Spinal dural arteriovenous malformations are the most common type of AVMs involving the spinal cord in adults. These lesions cause progressive sensory motor symptoms ranging from painful paraparesis to acute quadriplegia. AVMs are typically fed by radial dural arteries and are found in the dura adjacent to the dorsal nerve root (intervertebral foramen). The preferred treatment is direct obliteration of these lesions by either surgical resection or laser photocoagulation.
Sharon Salinas, CCS
Health Information Management
Barlow Respiratory Hospital
2000 Stadium Way, Los Angeles CA 90026
Tel: 213-250-4200 ext 3336
FAX: 213-202-6490
ssalinas@barlow2000.org
From: CDI Talk [mailto:cdi_talk@hcprotalk.com]
Sent: Wednesday, March 25, 2015 6:26 AM
To: Salinas, Sharon
Subject: [cdi_talk] Help with diagnosis
Has anyone had an opportunity to code an arteriovenous malformation of the thoracolumbar junction ?
This is a new diagnosis for us.
Thank you
Lisa Romanello, RN,BSN,FNS,CCDS
Manager, Clinical Documentation Improvement
Quality and Compliance
CJW Medical Center
Office phone: 804-228-6527
Cell phone: 804-629-0396
AHIMA Approved ICD-10 CM/PCS Trainer
Angelisa.Romanello@HCAHealthcare.com
---
CDI Talk is offered for networking purposes. For official rules and regulations related to documentation and coding, please refer to your regulatory source.
You are receiving this message as a member of CDI Talk as: ssalinas@barlow2000.org
If you would like to be removed from CDI Talk, please send a blank email to
leave-cdi_talk-12538092.1a48df689a710d0d4e067dc4c85563ef@hcprotalk.com
---
Copyright 2013
HCPro, Inc., 75 Sylvan Street, Danvers MA 01923
Confidentiality Notice: This e-mail message, including any attachments, is for the sole use of the intended recipient(s) and may contain confidential and privileged information. Any unauthorized review, use, disclosure or distribution is prohibited. If you are not the intended recipient, please contact the sender by reply e-mail and destroy all copies of the original message.
Comments
Lisa