Secondary malignant neoplasm of spine icd 10

Spinal cord compression secondary to neoplasm

Publication Date: May 2004

ICD 10 AM Edition: Third edition

Retired Date: 30/6/2010

Query Number: 1922

My query is in regard to the coding of spinal cord compression secondary to neoplasm.The example I have is a patient with rectal carcinoma experiencing spinal cord compression secondary to the cancer.I have coded
C20 Malignant neoplasm of rectum
M8010/3 Carcinoma NOS
G95.2 Cord compression, unspecified
However,
G99.2* Myelopathy in diseases classified elsewhereAnterior spinal and vertebral artery compression syndromes (M47.0-�)Myelopathy in neoplastic disease (C00�D48�)
seems to be more specific than the G95.2, but this code can only be reached by looking up the word myelopathy in the index. Question:Can the code G99.2 be used if �cord compression secondary to cancer� is documented, or does �myelopathy secondary to the cancer� have to be documented before this code can be assigned?

Response

Myelopathy is defined as �any functional disturbance and/or pathological change in the spinal cord� (Dorland�s Pocket Medical Dictionary, 24th edition, 1989).

Even though it is a term that could be applied to many conditions, it is seldom documented.
Committee members felt that coders should be able to use their clinical knowledge to interpret spinal cord compression as myelopathy, and therefore follow index entry:
Myelopathy (spinal cord) G95.9
- in (due to)
- - neoplastic disease NEC (M8000/1) (see also Neoplasm) D48.9� G99.2*

The NCCH agreed with this logic, and suggested that an additional code for the type of myelopathy be included. The idea of further specifying a condition where a code assigned is for �diseases classified elsewhere� is supported by the notion of �translating medical statements into codes�, which is the main aim of coding (refer to Guidance in the use of ICD-10-AM To classify clinical concepts into codes page xxiii of the ICD-10-AM Tabular list).

The correct codes to assign in this scenario are:
C20 Malignant neoplasm of rectum
M8010/3 Carcinoma NOS
G99.2* Myelopathy in diseases classified elsewhere
G95.2 Cord compression, unspecified

MDC 01 Diseases & Disorders of the Nervous System Nervous System Neoplasms

C700 Malignant neoplasm of cerebral meninges C701 Malignant neoplasm of spinal meninges C709 Malignant neoplasm of meninges, unspecified C710 Malignant neoplasm of cerebrum, except lobes and ventricles C711 Malignant neoplasm of frontal lobe C712 Malignant neoplasm of temporal lobe C713 Malignant neoplasm of parietal lobe C714 Malignant neoplasm of occipital lobe C715 Malignant neoplasm of cerebral ventricle C716 Malignant neoplasm of cerebellum C717 Malignant neoplasm of brain stem C718 Malignant neoplasm of overlapping sites of brain C719 Malignant neoplasm of brain, unspecified C720 Malignant neoplasm of spinal cord C721 Malignant neoplasm of cauda equina C7220 Malignant neoplasm of unspecified olfactory nerve C7221 Malignant neoplasm of right olfactory nerve C7222 Malignant neoplasm of left olfactory nerve C7230 Malignant neoplasm of unspecified optic nerve C7231 Malignant neoplasm of right optic nerve C7232 Malignant neoplasm of left optic nerve C7240 Malignant neoplasm of unspecified acoustic nerve C7241 Malignant neoplasm of right acoustic nerve C7242 Malignant neoplasm of left acoustic nerve C7250 Malignant neoplasm of unspecified cranial nerve C7259 Malignant neoplasm of other cranial nerves C729 Malignant neoplasm of central nervous system, unspecified C753 Malignant neoplasm of pineal gland C754 Malignant neoplasm of carotid body C755 Malignant neoplasm of aortic body and other paraganglia C7931 Secondary malignant neoplasm of brain C7932 Secondary malignant neoplasm of cerebral meninges C7940 Secondary malignant neoplasm of unspecified part of nervous system C7949 Secondary malignant neoplasm of other parts of nervous system D320 Benign neoplasm of cerebral meninges D321 Benign neoplasm of spinal meninges D329 Benign neoplasm of meninges, unspecified D330 Benign neoplasm of brain, supratentorial D331 Benign neoplasm of brain, infratentorial D332 Benign neoplasm of brain, unspecified D333 Benign neoplasm of cranial nerves D334 Benign neoplasm of spinal cord D337 Benign neoplasm of other specified parts of central nervous system D339 Benign neoplasm of central nervous system, unspecified D354 Benign neoplasm of pineal gland D355 Benign neoplasm of carotid body D356 Benign neoplasm of aortic body and other paraganglia D420 Neoplasm of uncertain behavior of cerebral meninges D421 Neoplasm of uncertain behavior of spinal meninges D429 Neoplasm of uncertain behavior of meninges, unspecified D430 Neoplasm of uncertain behavior of brain, supratentorial D431 Neoplasm of uncertain behavior of brain, infratentorial D432 Neoplasm of uncertain behavior of brain, unspecified D433 Neoplasm of uncertain behavior of cranial nerves D434 Neoplasm of uncertain behavior of spinal cord D438 Neoplasm of uncertain behavior of other specified parts of central nervous system D439 Neoplasm of uncertain behavior of central nervous system, unspecified D445 Neoplasm of uncertain behavior of pineal gland D446 Neoplasm of uncertain behavior of carotid body D447 Neoplasm of uncertain behavior of aortic body and other paraganglia D496 Neoplasm of unspecified behavior of brain

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