Blackhorse Posted Mon 29th of July, 2019 16:47:34 PM
Patient has persistent weakness in his legs after spine fusion surgery, which had progressed. He wears AFO's at baseline and has numbness and tingling in his feet. Sensation decreased subjectively to LT and PP throughout the lower extremities below the knees bilaterally. NCS results, sural sensory studies to the lateral malleolus were unresponsive bilaterally. Superficial peroneal sensory studies to the dorsal foot were unresponsive bilaterally. Tibial motor studies to AH were unresponsive bilaterally. Peroneal motor studies to EDB were unresponsive bilaterally. EMG: Monopolar needle electrode examination of selected muscles of the right and left lower extremities showed diffuse chronic denervation bilaterally in muscles below the knees with acute denervation (fibs and PSW's) in the right medical gastroc and FDL. Impression: 1. There is electrodiagnostic evidence of the severe sensorimotor demyelinating and axonopathic peripheral polyneuropathy. 2. There is electrodiagnostic evidence of a possible concomitant acute right L5/S1 radiculopathy but in the presence of his severe peripheral polyneuropathy it is difficult to differentiate. Can you explain to me what does it mean: "severe sensorimotor demyelinating and axonopathic peripheral polyneuropathy" and what ICD-10 codes that I should use for 95910 and 95886 with Medicare, Noridian LCD (California).
SuperCoder Answered Tue 30th of July, 2019 08:08:21 AM
Thanks for your question. Please find the answer below:
In the condition of Sensorimotor polyneuropathy, the patient has damaged nerves, has decreased ability to move the limbs, and is unable to feel any sensation.
Sensorimotor: nerves having both sensory and motor functions.
Demyelinating: nerves are covered with a protective layer which is called myelin, which is like insulation on electric wires. When this layer (myelin) is damaged, the nerve becomes naked from that place. This condition is called demyelinated nerve.
Axonopathy: a disorder disrupting the normal functioning of the axons of the nerves.
Neuropathy means disease of nerves (e.g. damage to nerves). Polyneuropathy means more than one nerves affected. These can be in different parts of the body.
ICD 10 CM code: There is one code G62.89 (Other specified polyneuropathies), which is appropriate to report for both the CPT codes (95910 and 95886).
Please feel free to write if you have any question.