'Department of Health and Human services, Victoria, Australia'

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Paraneoplastic syndrome

Publication Date: September 2018

ICD 10 AM Edition: Tenth edition

Retired Date: 30/6/2020

Query Number: 3376

Could you please advise on how to code 'paraneoplastic syndrome' (PNS)?

The example we had most recently was documented several ways including 'paraneoplastic cerebellar syndrome', 'paraneoplastic encephalitis' and 'paraneoplastic syndrome ataxia'. There are two codes in ICD-10-AM that appear to reflect this being G13.0 Paraneoplastic neuromyopathy and neuropathy and G13.1 Other systemic atrophy primarily affecting central nervous system in neoplastic disease. However, I don't have the words (such as neuropathy or encephalopathy) required to reach these codes through the index.

From internet searches it is apparent that there are many forms of PNS. However there do not appear to be the codes and index entries in the classification to support capturing this condition.

In this instance the symptoms that the patient had were dysarthria, dysphagia, ataxia and possible encephalitis with cerebellar signs. Final diagnosis was 'high grade serous pelvic carcinoma with paraneoplastic cerebellar syndrome'. Note 'pelvic because mass involves uterus, ovaries and peritoneum unable to determine primary site'.

Response

There is no one code for paraneoplastic syndrome although, as you have stated, there is a code for paraneoplastic neuromyopathy and neuropathy that require the documentation of these terms.

In the scenario cited, the documented manifestations were dysarthria, dysphagia, ataxia and possible encephalitis with cerebellar signs. Therefore, VICC advises to follow ACS 0005 Syndromes and assign a code for each of the manifestations.

You may wish to make a public submission to ACCD for a code for paraneoplastic syndrome not otherwise specified.