ICD-10 Coding for Neuromyelitis Optica(G36.0)
Complete ICD-10-CM coding and documentation guide for Neuromyelitis Optica. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Neuromyelitis Optica
G35-G37Primary Range
Demyelinating diseases of the central nervous system
This range includes codes for demyelinating diseases, with G36.0 specifically for neuromyelitis optica.
Key Information: ICD-10 code for neuromyelitis optica
Essential facts and insights about Neuromyelitis Optica
Primary ICD-10-CM Code for neuromyelitis optica
Decision Criteria
clinical Criteria
- Presence of AQP4-IgG antibodies and LETM on MRI
Applicable To
- Neuromyelitis optica spectrum disorder
Excludes
- Optic neuritis (H46)
Clinical Validation Requirements
- AQP4-IgG positivity
- Longitudinally extensive transverse myelitis (LETM)
- Optic neuritis
Code-Specific Risks
- Confusion with multiple sclerosis
- Incorrect use of optic neuritis code
Coding Notes
- Ensure documentation includes AQP4-IgG status and MRI findings.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Injection, inebilizumab-cdon, 1 mg
J1823Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Neuromyelitis Optica to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code G36.0.
Impact
Clinical: Inaccurate diagnosis and treatment planning., Regulatory: Non-compliance with documentation standards., Financial: Potential claim denials due to insufficient documentation.
Mitigation Strategy
Ensure MRI reports are included in patient records, Verify documentation before claim submission
Impact
Reimbursement: Incorrect coding may lead to denied claims., Compliance: Non-compliance with ICD-10 guidelines., Data Quality: Inaccurate clinical data representation.
Mitigation Strategy
Confirm NMOSD diagnosis with AQP4-IgG and MRI findings before coding.
Impact
Coding NMOSD without documented AQP4-IgG results.
Mitigation Strategy
Require serology documentation before coding.
Documentation errors, coding pitfalls, and audit risks are interconnected aspects of medical coding and billing. Addressing all three areas helps ensure accurate coding, optimal reimbursement, and regulatory compliance.
Frequently Asked Questions
Common questions about ICD-10 coding for Neuromyelitis Optica, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Neuromyelitis Optica
Use these documentation templates to ensure complete and accurate documentation for Neuromyelitis Optica. These templates include all required elements for proper coding and billing.
Initial NMOSD diagnosis
Specialty: NeurologyRequired Elements
- Patient history of optic neuritis
- MRI findings of LETM
- AQP4-IgG serology results
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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