Group 1 Procedure Codes:
92585 Auditor evoke potent compre
92586 Auditor evoke potent limit
Indications
Somatosensory Evoked Potentials and Responses (SEPs/SERs) (CPT codes 95925, 95926, 95927, 95928, 95929, 95938, 95939) are appropriate for the following indications:
Spinal cord trauma
Degenerative, non-traumatic spinal cord lesions (e.g., cervical spondylosis with myelopathy)
Multiple sclerosis
Spinocerebellar degeneration
Myoclonus
Coma
Intraoperative monitoring
Subacute combined degeneration
Other diseases of myelin (e.g., adrenoleukodystrophy, adrenomyeloneuropathy, metachromatic leukodystrophy, and Pelizaeus-Merzbacher disease
Syringomyelia
Hereditary spastic paraplegia
Brainstem Auditory Evoked Potentials and Responses (BAEPs/BAERs) (CPT codes 92585 and 92586) are appropriate:
For one or more of the following conditions:
Asymmetric hearing loss
Unilateral tinnitus
Sudden hearing loss
Cerebellopontine angle tumor
Demyelinating disorder
Functional hearing loss
Ototoxic drug therapy monitoring including chemotherapy or antibiotics
Auditory neuropathy
Acoustic neuroma
Preoperative baseline for:
Posterior fossa surgery
Cochlear implant
Postoperative testing for:
Cochlear implant
Visual Evoked Potentials or Responses (VEPs/VERs) (CPT code 95930) are appropriate for the following indications:
Confirm diagnosis of multiple sclerosis when clinical criteria are inconclusive.
Detect optic neuritis at an early, subclinical stage.
Evaluate diseases of the optic nerve, such as:
Ischemic optic neuropathy
Pseudotumor cerebri
Toxic amblyopias
Nutritional amblyopias
Neoplasms compressing the anterior visual pathways
Optic nerve injury or atrophy
Hysterical blindness (to rule out)
Monitor the visual system during optic nerve (or related) surgery (monitoring of short-latency evoked potential studies).
Limitations
SEP studies are appropriate only when a detailed clinical history and neurologic examination and appropriate diagnostic tests such as imaging studies, electromyogram, and nerve conduction studies make a lesion (or lesions) of the central somatosensory pathways a likely and reasonable differential diagnostic possibility.
There is no need for SEPs in the diagnosis of most neuropathies because the conventional nerve conduction study can identify them and no added information is obtained from SEPs.
Neurophysiological studies for purpose of this LCD include: Somatosensory Evoked Potentials/Responses (SEPs/SERs), Brainstem Auditory Evoked Potentials/Responses (BAEPs/BAERs) and Visual Evoked Potentials/Responses (VERs/VEPs).
Evoked potential studies are recorded electrical responses to stimulation of a sensory system. When a sensory impulse reaches the brain, a specific Electroencephalographic (EEG) response is produced (evoked) in the cortical area appropriate to the modality and site of the stimulus. By computer averaging techniques, the evoked responses of repetitive stimuli can be separated from the spontaneous EEG activity. Evoked potentials are clinically useful in evaluating the functional integrity of the somatosensory or special sensory pathways. Different latencies and wave patterns help to localize lesions ranging from the end organ through the nervous system to the cerebral cortex. Often defects in these pathways are not otherwise evident. Evoked potentials are also used to monitor neural pathways when patients are anesthetized during surgery and to document brain death. The following are tests that evaluate potentials evoked by stimulation of the peripheral or cranial nerves:
SEPs/SERs evaluate the pathways from nerves in the extremities through the spinal cord, to the brainstem or cerebral cortex upon stimulation of peripheral axon. Some conditions where SEPs have demonstrated usefulness include, but are not limited to the following: spinal cord trauma; subacute combined degeneration; non-traumatic spinal cord lesions, e.g., cervical spondylosis; multiple sclerosis; spinocerebellar degeneration; myoclonus; coma; and intraoperative monitoring of spinal cord, brainstem and brain sensory tracts.
SEP has an advantage in that it evaluates the entire somatosensory pathway and it is possible to distinguish between lesions located in the peripheral nerve, in the dorsal column pathway, or both. There is no need for SEP in the diagnosis of most neuropathies because the conventional nerve conduction study can identify them and no added information is obtained from SEP.
VEPs/VERs evaluate the visual nervous system pathways from the eyes to the occipital cortex of the brain. VER or VEP involves stimulation of the retina and optic nerve with a shifting checkerboard pattern or flash method. This external visual stimulus causes measurable electrical activity in neurons within the visual pathways. This is called the Visual Evoked Response (VER) and is recorded by electroencephalography electrodes located over the occiput. Using special computer techniques, the evoked responses measured over multiple trials are amplified and averaged. A characteristic waveform is produced. With pattern-shift VER, the waveform normally appears as a straight line with a single positive peak (100 msec after stimulus presentation). Abnormalities in this characteristic waveform may be seen in a variety of pathologic processes involving the optic nerve and its radiations. Pattern-shift VER is a highly sensitive means of documenting lesions in the visual system. It is especially useful when the disease process is subclinical, e.g., ophthalmologic exam is normal and patient lacks visual symptoms.
BAEPs/BAERs evaluate the auditory nerve pathways from the ears through the brain stem. A clicking sound is presented to one ear at a time. The electrical activity of this signal is recorded by electrodes on the scalp. The averaged response is displayed as a waveform that contains peaks and troughs, which correspond to various points along the hearing pathway. The time between these peaks is measured and compared to normal data. A delay in a component of the response might indicate an abnormality at specific anatomic sites in the acoustic nerve or brainstem.
Somatosensory Evoked Potentials (SEP) (CPT codes 95925, 95926, 95927) are appropriate for the following indications:
Evoked potential studies are recorded electrical responses to stimulation of a sensory system. When a sensory impulse reaches the brain, a specific Electroencephalographic (EEG) response is produced (evoked) in the cortical area appropriate to the modality and site of the stimulus. By computer averaging techniques, the evoked responses of repetitive stimuli can be separated from the spontaneous EEG activity. Evoked potentials are clinically useful in evaluating the functional integrity of the somatosensory or special sensory pathways. Different latencies and wave patterns help to localize lesions ranging from the end organ through the nervous system to the cerebral cortex. Often defects in these pathways are not otherwise evident. Evoked potentials are also used to monitor neural pathways when patients are anesthetized during surgery and to document brain death. The following are tests that evaluate potentials evoked by stimulation of the peripheral or cranial nerves:
SEPs/SERs evaluate the pathways from nerves in the extremities through the spinal cord, to the brainstem or cerebral cortex upon stimulation of peripheral axon. Some conditions where SEPs have demonstrated usefulness include, but are not limited to the following: spinal cord trauma; subacute combined degeneration; non-traumatic spinal cord lesions, e.g., cervical spondylosis; multiple sclerosis; spinocerebellar degeneration; myoclonus; coma; and intraoperative monitoring of spinal cord, brainstem and brain sensory tracts.
SEP has an advantage in that it evaluates the entire somatosensory pathway and it is possible to distinguish between lesions located in the peripheral nerve, in the dorsal column pathway, or both. There is no need for SEP in the diagnosis of most neuropathies because the conventional nerve conduction study can identify them and no added information is obtained from SEP.
VEPs/VERs evaluate the visual nervous system pathways from the eyes to the occipital cortex of the brain. VER or VEP involves stimulation of the retina and optic nerve with a shifting checkerboard pattern or flash method. This external visual stimulus causes measurable electrical activity in neurons within the visual pathways. This is called the Visual Evoked Response (VER) and is recorded by electroencephalography electrodes located over the occiput. Using special computer techniques, the evoked responses measured over multiple trials are amplified and averaged. A characteristic waveform is produced. With pattern-shift VER, the waveform normally appears as a straight line with a single positive peak (100 msec after stimulus presentation). Abnormalities in this characteristic waveform may be seen in a variety of pathologic processes involving the optic nerve and its radiations. Pattern-shift VER is a highly sensitive means of documenting lesions in the visual system. It is especially useful when the disease process is subclinical, e.g., ophthalmologic exam is normal and patient lacks visual symptoms.
BAEPs/BAERs evaluate the auditory nerve pathways from the ears through the brain stem. A clicking sound is presented to one ear at a time. The electrical activity of this signal is recorded by electrodes on the scalp. The averaged response is displayed as a waveform that contains peaks and troughs, which correspond to various points along the hearing pathway. The time between these peaks is measured and compared to normal data. A delay in a component of the response might indicate an abnormality at specific anatomic sites in the acoustic nerve or brainstem.
Somatosensory Evoked Potentials (SEP) (CPT codes 95925, 95926, 95927) are appropriate for the following indications:
- Spinal cord trauma.
- Degenerative, non-traumatic spinal cord lesions.
- Cervical spondylosis.
- Multiple sclerosis.
- Spinocerebellar degeneration.
- Myoclonus.
- Coma.
Brainstem Auditory Evoked Potentials and Responses (BAER, BAEP) (CPT codes 92585 and 92586) are appropriate when there is a history of one or more of the following conditions:
- Asymmetric hearing loss.
- Unilateral tinnitus.
- Sudden hearing loss.
- Suspected cerebellopontine angle tumor.
- Suspected demyelinating disorder.
- Suspected functional hearing loss.
- Ototoxic drug therapy monitoring including chemotherapy or antibiotics.
- Suspected auditory neuropathy.
- Suspected acoustic neuroma.
Preoperative baseline for:
- Posterior fossa surgery.
- Cochlear implant.
Postoperative testing for:
- Cochlear implant.
Visual Evoked Potentials or Responses (VEP, VER) (CPT code 95930) are appropriate for the following indications:
- Confirm diagnosis of multiple sclerosis when clinical criteria are inconclusive.
- Detect optic neuritis at an early, subclinical stage.
- Evaluate diseases of the optic nerve, such as:
- Ischemic optic neuropathy.
- Pseudotumor cerebri.
- Toxic amblyopias.
- Nutritional amblyopias.
- Neoplasms compressing the anterior visual pathways.
- Evaluate optic nerve injury.
- Hysterical blindness (to rule out).
- Monitor the visual system during optic nerve (or related) surgery (monitoring of short-latency evoked potential studies).
When performing SEP/SER, depending on the clinical condition being investigated, several nerves in one extremity may have to be tested and compared with the opposite limb.
See also “Intraoperative Neurophysiological Monitoring” LCD for coverage of other CPT/HCPCS code 95920 and “Vestibular and Audiologic Function Testing” LCD for coverage of CPT/HCPCS codes 92585 and 92586.
Contractors shall consider a service to be reasonable and necessary if the contractor determines that the service is:
- Safe and effective.
- Not experimental or investigational (exception: routine costs of qualifying clinical trial services with dates of service on or after September 19, 2000, which meet the requirements of the clinical trials NCD are considered reasonable and necessary).
- Appropriate, including the duration and frequency that is considered appropriate for the service, in terms of whether it is:
- Furnished in accordance with accepted standards of medical practice for the diagnosis or treatment of the patient’s condition or to improve the function of a malformed body member.
- Furnished in a setting appropriate to the patient’s medical needs and condition.
- Ordered and furnished by qualified personnel.
- One that meets, but does not exceed, the patient’s medical need.
- At least as beneficial as an existing and available medically appropriate alternative.
Bill Type Codes
Contractors may specify Bill Types to help providers identify those Bill Types typically used to report this service. Absence of a Bill Type does not guarantee that the policy does not apply to that Bill Type. Complete absence of all Bill Types indicates that coverage is not influenced by Bill Type and the policy should be assumed to apply equally to all claims.
12X, 13X, 18X, 21X, 22X, 23X, 28X, 71X, 73X, 74X, 75X, 77X, 85X
Bill Type Note: Code 73X end-dated for Medicare use March 31, 2010; code 77X effective for dates of service on or after April 1, 2010.
Revenue Codes
Contractors may specify Revenue Codes to help providers identify those Revenue Codes typically used to report this service. In most instances Revenue Codes are purely advisory; unless specified in the policy services reported under other Revenue Codes are equally subject to this coverage determination. Complete absence of all Revenue Codes indicates that coverage is not influenced by Revenue Code and the policy should be assumed to apply equally to all Revenue Codes.
Note: TrailBlazer has identified the Bill Type and Revenue Codes applicable for use with the CPT/HCPCS codes included in this LCD. Providers are reminded that not all the CPT/HCPCS codes listed can be billed with all Bill Type and/or Revenue Codes listed. CPT/HCPCS codes are required to be billed with specific Bill Type and Revenue Codes. Providers are encouraged to refer to the CMS Internet-Only Manual IOM Pub. 100-04 Claims Processing Manual for further guidance.
092X
CPT/HCPCS Codes
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Note:
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Providers are reminded to refer to the long descriptors of the CPT codes in their CPT book. The American Medical Association (AMA) and the Centers for Medicare & Medicaid Services (CMS) require the use of short CPT descriptors in policies published on the Web.
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95925©
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Somatosensory testing
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95926©
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Somatosensory testing
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95927©
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Somatosensory testing
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95928©
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C motor evoked, uppr limbs
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95929©
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C motor evoked, lwr limbs
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95930©
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Visual evoked potential test
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ICD-10 CODE DESCRIPTION
D33.3 Benign neoplasm of cranial nerves
G10 Huntington’s disease
G21.0 Malignant neuroleptic syndrome
G23.0 – G26 – Opens in a new window Hallervorden-Spatz disease – Extrapyramidal and movement disorders in diseases classified elsewhere
G35 – G36.8 – Opens in a new window Multiple sclerosis – Other specified acute disseminated demyelination
G37.0 – G37.8 – Opens in a new window Diffuse sclerosis of central nervous system – Other specified demyelinating diseases of central nervous system
G80.3 Athetoid cerebral palsy
G90.3 Multi-system degeneration of the autonomic nervous system
H46.00 – H46.9 – Opens in a new window Optic papillitis, unspecified eye – Unspecified optic neuritis
H81.01 – H81.09 – Opens in a new window Meniere’s disease, right ear – Meniere’s disease, unspecified ear
H81.41 – H81.49 – Opens in a new window Vertigo of central origin, right ear – Vertigo of central origin, unspecified ear
H83.3X1 – H83.3X9 – Opens in a new window Noise effects on right inner ear – Noise effects on inner ear, unspecified ear
H90.3 – H90.8 – Opens in a new window Sensorineural hearing loss, bilateral – Mixed conductive and sensorineural hearing loss, unspecified
H91.20 – H91.23 – Opens in a new window Sudden idiopathic hearing loss, unspecified ear – Sudden idiopathic hearing loss, bilateral
H93.11 – H93.19 – Opens in a new window Tinnitus, right ear – Tinnitus, unspecified ear
H93.3X1 – H93.3X9 – Opens in a new window Disorders of right acoustic nerve – Disorders of unspecified acoustic nerve
H94.00 – H94.03 – Opens in a new window Acoustic neuritis in infectious and parasitic diseases classified elsewhere, unspecified ear – Acoustic neuritis in infectious and parasitic diseases classified elsewhere, bilateral
R25.0 – R25.9 – Opens in a new window Abnormal head movements – Unspecified abnormal involuntary movements
R42 Dizziness and giddiness
Showing 1 to 19 of 19 entries in Group 1
FirstPrevCurrently Selected1NextLast
ICD-9-CM Codes that Support Medical Necessity
The CPT/HCPCS codes included in this policy will be subjected to “procedure to diagnosis” editing. The following lists include only those diagnoses for which the identified CPT/HCPCS procedures are covered. If a covered diagnosis is not on the claim, the edit will automatically deny the service as not medically necessary.
Medicare is establishing the following limited coverage for CPT/HCPCS codes 95925, 95926, 95927, 95928, 95929 and 95930:
Covered for:
|
036.81
|
Meningococcal optic neuritis
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|
054.3
|
Herpetic meningoencephalitis
|
|
055.0
|
Postmeasles encephalitis
|
|
056.01
|
Encephalomyelitis due to rubella
|
|
062.0–062.5
|
Encephalitis
|
|
062.8–062.9
|
Other specified mosquito-borne viral encephalitis
|
|
063.0–063.2
|
Russian spring-summer (taiga) encephalitis
|
|
063.8–063.9
|
Tick-borne viral encephalitis
|
|
064
|
Viral encephalitis transmitted by other and unspecified arthropods
|
|
088.81
|
Lyme disease
|
|
094.0–094.2
|
Tabes dorsalis
|
|
094.81–094.89
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Syphilitic
|
|
094.9
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Neurosyphilis unspecified
|
|
170.2
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Malignant neoplasm of vertebral column excluding sacrum and coccyx
|
|
192.0–192.3
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Malignant neoplasm of cranial nerves
|
|
192.8–192.9
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Malignant neoplasm of other specified sites of nervous system
|
|
198.3–198.4
|
Secondary malignant neoplasm of brain and spinal cord
|
|
225.0–225.4
|
Benign neoplasm of brain
|
|
225.8–225.9
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Benign neoplasm of other specified sites of nervous system
|
|
237.0–237.1
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Neoplasm of uncertain behavior of pituitary gland and craniopharyngeal duct
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|
237.5–237.6
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Neoplasm of uncertain behavior of brain and spinal cord
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|
237.70–237.73
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Neurofibromatosis unspecified
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|
237.79
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Other neurofibromatosis
|
|
237.9
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Neoplasm of uncertain behavior of other and unspecified parts of nervous system
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|
239.6
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Neoplasm of unspecified nature of brain
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|
300.11
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Conversion disorder
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|
324.1
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Intraspinal abscess
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|
333.0
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Other degenerative diseases of the basal ganglia
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|
333.79
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Other acquired torsion dystonia
|
|
334.0–334.4
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Friedreich’s ataxia
|
|
334.8–334.9
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Other spinocerebellar diseases
|
|
336.0–336.3
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Syringomyelia and syringobulbia
|
|
336.8–336.9
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Other myelopathy
|
|
340
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Multiple sclerosis
|
|
341.0–341.1
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Neuromyelitis optica
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|
341.20–341.22
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Acute (transverse) myelitis nos
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|
341.8–341.9
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Other demyelinating diseases of central nervous system
|
|
342.00–342.02
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Flaccid hemiplegia and hemiparesis affecting unspecified side
|
|
342.10–342.12
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Spastic hemiplegia and hemiparesis affecting unspecified side
|
|
342.80–342.82
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Other specified hemiplegia and hemiparesis affecting unspecified side
|
|
342.90–342.92
|
Unspecified hemiplegia and hemiparesis affecting unspecified side
|
|
343.0–343.4
|
Congenital diplegia
|
|
343.8–343.9
|
Other specified infantile cerebral palsy
|
|
348.2
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Benign intracranial hypertension
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|
350.1–350.2
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Trigeminal neuralgia
|
|
350.8–350.9
|
Other specified trigeminal nerve disorders
|
|
351.0
|
Bell’s palsy
|
|
351.8–351.9
|
Other facial nerve disorders
|
|
352.0
|
Disorders of olfactory (1st) nerve
|
|
352.2–352.6
|
Disorders of other cranial nerves
|
|
352.9
|
Unspecified disorder of cranial nerves
|
|
353.0–353.6
|
Brachial plexus lesions
|
|
353.8–353.9
|
Other nerve root and plexus disorders
|
|
354.0–354.5
|
Carpal tunnel syndrome
|
|
354.8–354.9
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Other mononeuritis of upper limb
|
|
355.0–355.6
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Lesion of sciatic nerve
|
|
355.71
|
Causalgia of lower limb
|
|
355.79
|
Other mononeuritis of lower limb
|
|
355.8–355.9
|
Mononeuritis of lower limb unspecified
|
|
356.0–356.4
|
Hereditary peripheral neuropathy
|
|
356.8–356.9
|
Other specified idiopathic peripheral neuropathy
|
|
357.0–357.7
|
Acute infective polyneuritis
|
|
357.81–357.82
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Chronic inflammatory demyelinating polyneuritis
|
|
357.89
|
Other inflammatory and toxic neuropathy
|
|
357.9
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Unspecified inflammatory and toxic neuropathies
|
|
358.00–358.01
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Myasthenia gravis
|
|
358.1–358.2
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Myasthenic syndromes in diseases classified elsewhere
|
|
358.8–358.9
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Other specified myoneural disorders
|
|
368.00–368.03
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Amblyopia unspecified
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|
368.10–368.16
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Subjective visual disturbance unspecified
|
|
368.2
|
Diplopia
|
|
368.30–368.34
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Binocular vision disorder unspecified
|
|
368.40–368.47
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Visual field defect unspecified
|
|
368.51–368.55
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Protan defect
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|
368.59
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Other color vision deficiencies
|
|
368.60–368.63
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Night blindness unspecified
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|
368.69
|
Other night blindness
|
|
368.8–368.9
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Other specified visual disturbances
|
|
377.00–377.04
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Papilledema unspecified
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|
377.10–377.15
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Optic atrophy unspecified
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|
377.21–377.24
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Drusen of optic disc
|
|
377.30–377.34
|
Optic neuritis unspecified
|
|
377.39
|
Other optic neuritis
|
|
377.41–377.42
|
Ischemic optic neuropathy
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|
377.49
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Other disorders of optic nerve
|
|
377.51–377.54
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Disorders of optic chiasm associated with pituitary neoplasms and disorders
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|
377.61–377.63
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Disorders of other visual pathways associated with neoplasms
|
|
377.71–377.73
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Disorders of visual cortex associated with neoplasms
|
|
377.75
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Cortical blindness
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|
377.9
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Unspecified disorder of optic nerve and visual pathways
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|
386.00–386.04
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Meniere’s disease unspecified
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|
386.10–386.12
|
Peripheral vertigo unspecified
|
|
386.19
|
Other peripheral vertigo
|
|
386.2
|
Vertigo of central origin
|
|
386.30–386.35
|
Labyrinthitis unspecified
|
|
386.40–386.43
|
Labyrinthine fistula unspecified
|
|
386.48
|
Labyrinthine fistula of combined sites
|
|
386.50–386.56
|
Labyrinthine dysfunction unspecified
|
|
386.58
|
Other forms and combinations of labyrinthine dysfunction
|
|
386.8–386.9
|
Other disorders of labyrinth
|
|
388.00–388.02
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Degenerative and vascular disorders unspecified
|
|
388.10–388.12
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Noise effects on inner ear unspecified
|
|
388.2
|
Sudden hearing loss unspecified
|
|
388.30–388.32
|
Tinnitus
|
|
388.40–388.44
|
Abnormal auditory perception unspecified
|
|
388.5
|
Disorders of acoustic nerve
|
|
388.60–388.61
|
Otorrhea unspecified
|
|
388.69
|
Other otorrhea
|
|
388.70–388.72
|
Otalgia unspecified
|
|
388.8–388.9
|
Other disorders of ear
|
|
389.00–389.04
|
Conductive hearing loss
|
|
389.08
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Conductive hearing loss of combined types
|
|
389.10–389.12
|
Sensorineural hearing loss unspecified
|
|
389.14–389.16
|
Central hearing loss, bilateral
|
|
389.18
|
Sensorineural hearing loss of combined types, bilateral
|
|
389.20–389.22
|
Mixed conductive and sensorineural hearing loss
|
|
389.7–389.9
|
Deaf mutism not elsewhere classifiable
|
|
430–431
|
Subarachnoid hemorrhage
|
|
432.0–432.1
|
Nontraumatic extradural hemorrhage
|
|
432.9
|
Unspecified intracranial hemorrhage
|
|
433.00–433.01
|
Occlusion and stenosis of basilar artery
|
|
433.10–433.11
|
Occlusion and stenosis of carotid artery
|
|
433.20–433.21
|
Occlusion and stenosis of vertebral artery
|
|
433.30–433.31
|
Occlusion and stenosis of multiple and bilateral precerebral arteries
|
|
433.80–433.81
|
Occlusion and stenosis of other specified precerebral artery
|
|
433.90–433.91
|
Occlusion and stenosis of unspecified precerebral artery
|
|
434.00–434.01
|
Cerebral thrombosis
|
|
434.10–434.11
|
Cerebral embolism
|
|
434.90–434.91
|
Cerebral artery occlusion unspecified
|
|
435.0–435.3
|
Basilar artery syndrome
|
|
435.8–435.9
|
Other specified transient cerebral ischemias
|
|
437.3
|
Cerebral aneurysm nonruptured
|
|
441.00–441.03
|
Dissection of aorta aneurysm unspecified site
|
|
441.1–441.7
|
Thoracic aneurysm ruptured
|
|
441.9
|
Aortic aneurysm of unspecified site without rupture
|
|
721.1
|
Cervical spondylosis with myelopathy
|
|
721.41–721.42
|
Spondylosis with myelopathy thoracic region
|
|
721.91
|
Spondylosis of unspecified site with myelopathy
|
|
722.70–722.73
|
Intervertebral disc disorder with myelopathy
|
|
723.2–723.3
|
Other disorders of cervical region
|
|
737.0
|
Adolescent postural kyphosis
|
|
737.10–737.12
|
Kyphosis (acquired) (postural)
|
|
737.19
|
Other kyphosis acquired
|
|
737.20–737.22
|
Lordosis (acquired) (postural)
|
|
737.29
|
Other lordosis acquired
|
|
737.30–737.34
|
Scoliosis (and kyphoscoliosis) idiopathic
|
|
737.39
|
Other kyphoscoliosis and scoliosis
|
|
737.40–737.43
|
Unspecified curvature of spine associated with other conditions
|
|
737.8–737.9
|
Other curvatures of spine associated with other conditions
|
|
741.00–741.03
|
Spina bifida unspecified region with hydrocephalus
|
|
741.90–741.93
|
Spina bifida unspecified region without hydrocephalus
|
|
780.01
|
Coma
|
|
780.03
|
Persistent vegetative state
|
|
780.4
|
Dizziness and giddiness
|
|
781.2–781.4
|
Abnormality of gait
|
|
782.0
|
Disturbance of skin sensation
|
|
794.10–794.17
|
Nonspecific abnormal response to unspecified nerve stimulation
|
|
794.19
|
Other nonspecific abnormal results of function study of peripheral nervous system and special senses
|
|
806.00–806.09
|
Closed fracture of c1-c4 level
|
|
806.10–806.19
|
Open fracture of c1-c4 level
|
|
806.20–806.29
|
Closed fracture of t1-t6 level
|
|
806.30–806.39
|
Open fracture of t1-t6 level
|
|
806.4–806.5
|
Closed fracture of lumbar spine
|
|
806.60–806.62
|
Closed fracture of sacrum and coccyx
|
|
806.69
|
Closed fracture of sacrum and coccyx with other spinal cord injury
|
|
806.70–806.72
|
Open fracture of sacrum and coccyx with unspecified spinal cord injury
|
|
806.79
|
Open fracture of sacrum and coccyx with other spinal cord injury
|
|
806.8–806.9
|
Closed fracture of unspecified vertebra with spinal cord injury
|
|
850.4–850.5
|
Concussion with prolonged loss of consciousness without return to pre-existing conscious level
|
|
850.9
|
Concussion unspecified
|
|
851.00–851.06
|
Cortex (cerebral) contusion without open intracranial wound state of consciousness unspecified
|
|
851.09
|
Cortex (cerebral) contusion without open intracranial wound with concussion unspecified
|
|
851.10–851.16
|
Cortex (cerebral) contusion with open intracranial wound
|
|
851.19
|
Cortex (cerebral) contusion with open intracranial wound with concussion, unspecified
|
|
851.20–851.26
|
Cortex (cerebral) laceration without open intracranial wound with state of consciousness unspecified
|
|
851.29
|
Cortex (cerebral) laceration without open intracranial wound with concussion unspecified
|
|
851.30–851.36
|
Cortex (cerebral) laceration with open intracranial wound with state of consciousness unspecified
|
|
851.39
|
Cortex (cerebral) laceration with open intracranial wound with concussion unspecified
|
|
851.40–851.46
|
Cerebellar or brain stem contusion without open intracranial wound with state of consciousness unspecified
|
|
851.49
|
Cerebellar or brain stem contusion without open intracranial wound with concussion unspecified
|
|
851.50–851.56
|
Cerebellar or brain stem contusion with open intracranial wound with state of consciousness unspecified
|
|
851.59
|
Cerebellar or brain stem contusion with open intracranial wound with concussion unspecified
|
|
851.60–851.66
|
Cerebellar or brain stem laceration without open intracranial wound with state of consciousness unspecified
|
|
851.69
|
Cerebellar or brain stem laceration without open intracranial wound with concussion unspecified
|
|
851.70–851.76
|
Cerebellar or brain stem laceration with open intracranial wound with state of consciousness unspecified
|
|
851.79
|
Cerebellar or brain stem laceration with open intracranial wound with concussion unspecified
|
|
851.80–851.86
|
Other and unspecified cerebral laceration and contusion without open intracranial wound with state of consciousness unspecified
|
|
851.89
|
Other and unspecified cerebral laceration and contusion without open intracranial wound with concussion unspecified
|
|
851.90–851.96
|
Other and unspecified cerebral laceration and contusion with open intracranial wound with state of consciousness unspecified
|
|
851.99
|
Other and unspecified cerebral laceration and contusion with open intracranial wound with concussion unspecified
|
|
852.00–852.06
|
Subarachnoid hemorrhage following injury without open intracranial wound with state of consciousness unspecified
|
|
852.09
|
Subarachnoid hemorrhage following injury without open intracranial wound with concussion unspecified
|
|
852.10–852.16
|
Subarachnoid hemorrhage following injury with open intracranial wound with state of consciousness unspecified
|
|
852.19
|
Subarachnoid hemorrhage following injury with open intracranial wound with concussion unspecified
|
|
852.20–852.26
|
Subdural hemorrhage following injury without open intracranial wound with state of consciousness unspecified
|
|
852.29
|
Subdural hemorrhage following injury without open intracranial wound with concussion unspecified
|
|
852.30–852.36
|
Subdural hemorrhage following injury with open intracranial wound with state of consciousness unspecified
|
|
852.39
|
Subdural hemorrhage following injury with open intracranial wound with concussion unspecified
|
|
852.40–852.46
|
Extradural hemorrhage following injury without open intracranial wound with state of consciousness unspecified
|
|
852.49
|
Extradural hemorrhage following injury without open intracranial wound with concussion unspecified
|
|
852.50–852.56
|
Extradural hemorrhage following injury with open intracranial wound with state of consciousness unspecified
|
|
852.59
|
Extradural hemorrhage following injury with open intracranial wound with concussion unspecified
|
|
853.00–853.06
|
Other and unspecified intracranial hemorrhage following injury without open intracranial wound with state of consciousness unspecified
|
|
853.09
|
Other and unspecified intracranial hemorrhage following injury without open intracranial wound with concussion unspecified
|
|
853.10–853.16
|
Other and unspecified intracranial hemorrhage following injury with open intracranial wound with state of consciousness unspecified
|
|
853.19
|
Other and unspecified intracranial hemorrhage following injury with open intracranial wound with concussion unspecified
|
|
907.1–907.5
|
Late effect of injury to cranial nerve
|
|
950.0–950.3
|
Optic nerve injury
|
|
950.9
|
Injury to unspecified optic nerve and pathways
|
|
952.00–952.09
|
C1-c4 level spinal cord injury unspecified
|
|
952.10–952.19
|
T1-t6 level spinal cord injury unspecified
|
|
952.2–952.4
|
Lumbar spinal cord injury without spinal bone injury
|
|
952.8–952.9
|
Multiple sites of spinal cord injury without spinal bone injury
|
|
953.0–953.5
|
Injury to cervical nerve root and spinal plexus
|
|
953.8–953.9
|
Injury to multiple sites of nerve roots and spinal plexus
|
|
954.0–954.1
|
Injury to cervical sympathetic nerve excluding shoulder and pelvic girdles
|
|
954.8–954.9
|
Injury to other specified nerve(s) of trunk excluding shoulder and pelvic girdles
|
|
955.0–955.9
|
Injury to axillary nerve
|
|
956.0–956.5
|
Injury to sciatic nerve
|
|
956.8–956.9
|
Injury to multiple nerves of pelvic girdle and lower limb
|
|
957.0–957.1
|
Injury to superficial nerves of head and neck
|
|
957.8–957.9
|
Injury to multiple nerves in several parts
|
|
V58.62
|
Long-term (current) use of antibiotics
|
|
V58.69
|
Long-term (current) use of other medications
|
Note: Providers should continue to submit ICD-9-CM diagnosis codes without decimals on their claim forms and electronic claims.
