Multiple Sclerosis ICD 10 Code

Refresher: What are ICD-10 codes?

The World Health Organization realized that collecting statistical data and medical information from its extensive list of member countries was becoming a true hassle due to language barriers. There was no way to confirm if any two pieces of literature truly discussed the same condition or type of injury. They devised a standardized code to classify all known diseases, procedures, and symptoms in this situation.

In 1893, the International Statistical Institute published the first edition of the International List of Causes of Death. This was later developed by the WHO and revised several times before the code was named the International Classification of Disease or the ICD. Its tenth version is currently in use, called the ICD 10 code.

All countries that adopted this code included their own changes and alterations. In the US, the coding system has been modified to ICD-10 CM. CM stands for “Clinical Modification.” The ICD 10 CM is an alphanumeric code that is relied upon for medical documentation, insurance, billing, reimbursement, and statistical research.

What is the ICD 10 code for Multiple Sclerosis?

For Multiple Sclerosis, the general ICD-10 code is ICD Code G35 (Demyelinating diseases of the central nervous system). Multiple Sclerosis is an autoimmune disorder, markedly more commonly affecting women between the ages of twenty and fifty, in which the body's immune system causes demyelination and axonal damage in the nervous system.

The immune system becomes confused and starts attacking the coating on nerves known as the myelin sheath. This sheath is integral to the proper functioning of nerves and synapses. The disorder is accompanied by symptoms including numbness, fatigue, loss of coordination, difficulty speaking, loss of touch/sensation, blurred vision, mood changes, and painful spasms.

The cause of the disease is unknown. However, it’s believed that both genetic and environmental triggers have a role. Symptoms are different according to where the degeneration of the nervous system lies. Regardless of the area attacked in the nervous system or the prominent symptoms, all Multiple Sclerosis diagnoses fall under ICD Code G35. That means the ICD 10 code for Relapsin-Remitting Multiple Sclerosis, Secondary Progressive Multiple Sclerosis, Primary Progressive Multiple Sclerosis, and Primary Relapsing Multiple Sclerosis is the same.

Primary Multiple Sclerosis ICD 10 code:

Primary Multiple Sclerosis ICD code G35 lookup

Below is a table of the ICD 10 Multiple Sclerosis codes for Multiple Sclerosis, which are classified under G35, “Demyelinating diseases of the central nervous system.”[¹]

G35: Demyelinating diseases of the central nervous system

Types of Multiple Sclerosis coded under G35

The ICD 10 code G35 does not specify the subtype of Multiple Sclerosis. A G35 code can be used for Multiple Sclerosis presenting in various types:

• Multiple sclerosis
• Relapsing-Remitting MS (RRMS)
• Secondary Progressive MS (SPMS)
• Primary Progressive MS (PPMS)
• Progressive Relapsing MS (PRMS)

In other words, Multiple Sclerosis is classified based on how it presents, whether in progressive or relapse states. The affected area does not count. For example, Multiple Sclerosis with symptoms related to touch, bladder, or vision would all be coded with G35.1 if it continuously progressed regularly. Someone with progressively severe painful spasms and someone else with progressively worsening eyesight would be diagnosed with Primary Progressive Multiple Sclerosis under code G35.1 despite having damage in different parts of the nervous system because of the progressive nature of the disease.

Demyelinating diseases of the central nervous system excluded from ICD-10 Code G35

One type 1 and one type 2 Demyelinating disease of the central nervous system are excluded from ICD-10 code G35. Acute Transverse Myelitis (ATM) is another disease in which the myelin sheath protecting neurons is damaged alongside axons. However, this is a separate disease from Multiple sclerosis and has its own ICD-10 code, G37.3 (Acute transverse myelitis in demyelinating disease of the central nervous system).

Acute Transverse Myelitis has a type 1 exclusion from ICD-10 code G35. That means that both diseases cannot be reported together. Medically, it can either be one or the other, causing the demyelination of the central and periphery nervous system. To ensure there is no confusion, only one of these conditions can be reported at a time.

On the other hand, cute disseminated encephalomyelitis (ADEM) is a type two exclusion. That means that although it has it is a separate condition with its own ICD-10 code, G04 (Encephalitis, myelitis, and encephalomyelitis), it can exist simultaneously and be coded alongside Multiple sclerosis. However, they cannot be confused for the same condition and must be properly documented separately. The type-2 exclusion ensures that medical staff does not conflate both conditions as synonymous.

Secondary Multiple Sclerosis ICD 10 code: G35.1

Secondary or metastatic Multiple Sclerosis ICD-10 code G35.1 lookup

The ICD 10 Multiple Sclerosis Code for secondary Multiple Sclerosis, or secondary progressive multiple sclerosis (SPMS), is G35.1, “Multiple sclerosis with progressive course.”[²]

Secondary Multiple Sclerosis or Secondary Progressive Multiple Sclerosis does not have further subtypes within its classification. However, cases may differ according to the affected area of the central nervous system.

Conclusion

The ICD-10 CM is an alphanumeric code that the US developed by modifying the already existing ICD-10 code developed by the WHO. It is used for everything from billing to medical statistics. Multiple Sclerosis is a progressive autoimmune neurogenerative disease causing demyelination and axonal damage of the central nervous system. The type of Multiple Sclerosis depends on if it presents itself in a progressive or relapsing form and does not concern what part of the CNS is affected.