Download ICD-9-CM coding for patients with Tourette syndrome* Comorbid

ICD-9-CM coding for patients with Tourette syndrome*
*** indicates intervening codes have been left out of this list.
5. MENTAL DISORDERS (290-319)
PSYCHOSES (290-299)
NEUROTIC DISORDERS, PERSONALITY DISORDERS, AND OTHER NONPSYCHOTIC MENTAL
DISORDERS (300-316)
307
Special symptoms or syndromes, not elsewhere classified
***
307.2
Excludes:
Tics
nail-biting or thumb-sucking (307.9)
stereotypes occurring in isolation (307.3)
tics of organic origin (333.3)
307.20 Tic disorder, unspecified
Tic disorder NOS
307.21 Transient tic disorder
307.22 Chronic motor or vocal tic disorder
307.23 Tourette's disorder
Motor-verbal tic disorder
307.3
Excludes:
Stereotypic movement disorder
Body-rocking
Head banging
Spasmus nutans
Stereotypes NOS
tics (307.20-307.23)
of organic origin (333.3)
NOTE: Insurance compensation for services for patients with TS is complicated by the diagnosis being in ICD-9’s
290-319 series (mental disorders), which may trigger use of mental health benefit rules rather than those for medical
benefits. This despite clear evidence confirming it as a neurological disorder. Using 348.3 (static encephalopathy) or
349.9 (unspecified nervous system disorder), along with the code for TS (307.23), may result in appropriate
compensation. If payment is denied, an appeal letter to the insurance company specifying that TS is a neurological
disorder and attaching the NIH fact sheet (http://www.ninds.nih.gov/disorders/tourette/detail_tourette.htm) may help.
Adapted from: Zinner, SH. Tourette syndrome - much more than tics; Second of two parts, Management
tailored to the entire patient Contemporary Pediatrics. 2004;21(8):38-49.
***
348
Other conditions of brain
***
348.3
Encephalopathy, not elsewhere classified
***
349
Other and unspecified disorders of the nervous system
***
349.9
Unspecified disorders of nervous system
Disorder of nervous system (central) NOS
Comorbid disorders found with Tourette syndrome
300
Anxiety, dissociative and somatoform disorders
300.0
Anxiety states
Excludes:
anxiety in:
acute stress reaction (308.0)
transient adjustment reaction (309.24)
neurasthenia (300.5)
psychophysiological disorders (306.0-306.9)
separation anxiety (309.21)
***
300.02 Generalized anxiety disorder
***
300.3
Excludes:
Obsessive-compulsive disorders
Anancastic neurosis
Compulsive neurosis
Obsessional phobia [any]
obsessive-compulsive symptoms occurring in:
endogenous depression (296.2-296.3)
organic states (e.g., encephalitis) schizophrenia (295.0-295.9)
***
313
Disturbance of emotions specific to childhood and adolescence
Excludes:
adjustment reaction (309.0-309.9)
emotional disorder of neurotic type (300.0-300.9)
masturbation, nail-biting, thumb-sucking, and other isolated symptoms (307.0-307.9)
313.0
Excludes:
Overanxious disorder
Anxiety and fearfulness of childhood and adolescence
Overanxious disorder of childhood and adolescence
abnormal separation anxiety (309.21)
anxiety states (300.00-300.09)
hospitalism in children (309.83)
phobic state (300.20-300.29)
***
314
Hyperkinetic syndrome of childhood
Excludes:
hyperkinesis as symptom of underlying disorder-code the underlying disorder
314.0
Attention deficit disorder
Adult
Child
314.00 Without mention of hyperactivity
Predominantly inattentive type
314.01 With hyperactivity
Combined type
Overactivity NOS
Predominantly hyperactive/impulsive type
Simple disturbance of attention with overactivity
th
* Abstracted from International Classification of Diseases, 9 revision, Clinical Modification, issued by the US
Department of Health and Human Services. Available in electronic versions from http://www.cdc.gov/nchs/icd9.htm.
Published copies of ICD-9-CM are available from a variety of sources and should be found in any medical library.