Understanding ICD-9-CM Coding Mary Jo Bowie MS, RHIA, RHIT Regina Schaffer AAS, RHIA, CPC

Diseases of the Nervous System and Sense Organs CHAPTER 11

Nervous System Controls all bodily activities Two main parts: Central Nervous System (CNS) Peripheral Nervous System (PNS)

Coding Diseases of Central Nervous System (CNS) Inflammatory Diseases 320–326 Hereditary & Degenerative Diseases 330–337 Other Headache Syndromes 339 Other Diseases of the CNS 340–349

Category Codes for PNS and Sense Organs Peripheral Nervous System 350–359 Eye and Adnexa 360–379 Ear and Mastoid Process 380–389

Inflammatory Diseases of CNS Instructional notes can be difficult Reference to Alphabetic and Tabular List May require assignment of two codes

Meningitis Inflammation of the meninges Can be caused by: Bacteria or nonbacterial Viral Aseptic Manifestation of another disease Code classification according to cause

Other Conditions Encephalitis Myelitis Encephalomyelitis

Hereditary and Degenerative Diseases of CNS Alzheimer’s Disease Dementia Parkinson’s Disease Disorders of autonomic nervous system Parasympathetic Sympathetic—“fight-or-flight”

Other Disorders of CNS Multiple sclerosis Hemiplegia Hemiparesis Cerebrovascular accident (CVA) Cerebral palsy Epilepsy

Disorders of PNS 12 pairs of cranial nerves Identified by Roman numerals Injury to any cranial nerves coded to these categories

Disorders of the Eye and Adnexa Adnexa—accessory or appendage Very detailed coding Resources are very important to understanding eye anatomy Conditions would include Conjunctivitis Cataracts

Diseases of the Ear and Mastoid Process External, middle, and inner ear Conditions encountered Conductive hearing loss Otosclerosis