AHA Coding Clinic® for ICD-10-CM and ICD-10-PCS - 2023 Issue 3; Ask the Editor

Cervical Epidural Hematoma

A patient presents due to left upper and lower extremity weakness. A cervical epidural hematoma compressing the cervical spinal cord was found on magnetic resonance imaging. The provider’s final diagnosis lists, “Cervical epidural hematoma, no trauma or procedures.” The patient underwent surgical decompression and evacuation of the epidural hematoma. What is the correct ICD-10-CM diagnosis code assignment for cervical epidural hematoma that is documented as not being due to a procedure or an injury? ...

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