1. Understanding ICD-9-CM Coding Mary Jo Bowie MS, RHIA, RHIT Regina Schaffer AAS, RHIA, CPC

2. CHAPTER 11 Diseases of the Nervous System and Sense Organs

3. Nervous System • Controls all bodily activities • Two main parts: • Central Nervous System (CNS) • Peripheral Nervous System (PNS)

5. Coding Diseases of Central Nervous System (CNS) • Inflammatory Diseases 320–326 • Hereditary & Degenerative Diseases 330–337 • Other Headache Syndromes 339 • Other Diseases of the CNS 340–349

6. Category Codes for PNS and Sense Organs • Peripheral Nervous System 350–359 • Eye and Adnexa 360–379 • Ear and Mastoid Process 380–389

7. Inflammatory Diseases of CNS • Instructional notes can be difficult • Reference to Alphabetic and Tabular List • May require assignment of two codes

8. Meningitis • Inflammation of the meninges • Can be caused by: • Bacteria or nonbacterial • Viral • Aseptic • Manifestation of another disease • Code classification according to cause

9. Other Conditions • Encephalitis • Myelitis • Encephalomyelitis

10. Hereditary and Degenerative Diseases of CNS • Alzheimer’s Disease • Dementia • Parkinson’s Disease • Disorders of autonomic nervous system • Parasympathetic • Sympathetic—“fight-or-flight”

11. Other Disorders of CNS • Multiple sclerosis • Hemiplegia • Hemiparesis • Cerebrovascular accident (CVA) • Cerebral palsy • Epilepsy

13. Disorders of PNS • 12 pairs of cranial nerves • Identified by Roman numerals • Injury to any cranial nerves coded to these categories

15. Disorders of the Eyeand Adnexa • Adnexa—accessory or appendage • Very detailed coding • Resources are very important to understanding eye anatomy • Conditions would include • Conjunctivitis • Cataracts

17. Diseases of the Ear and Mastoid Process • External, middle, and inner ear • Conditions encountered • Conductive hearing loss • Otosclerosis