Find comprehensive information on Transverse Myelitis diagnosis, including clinical documentation, medical coding (ICD-10 G37.3), symptoms, treatment, and prognosis. This resource covers key aspects for healthcare professionals, offering insights into differential diagnosis, diagnostic criteria, and best practices for accurate medical record keeping related to Transverse Myelitis. Learn about the neurological exam findings and MRI changes associated with Transverse Myelitis for improved patient care and coding accuracy.
Also known as
Transverse Myelitis
Inflammation of the spinal cord affecting both sides.
Other encephalomyelitis
Encephalomyelitis not classified elsewhere, possibly including transverse myelitis.
Anterior horn cell disorders
Conditions affecting motor neurons, sometimes mimicking transverse myelitis symptoms.
Other specified systemic involvement of connective tissue
Connective tissue disorders can sometimes cause symptoms similar to transverse myelitis.
Follow this step-by-step guide to choose the correct ICD-10 code.
Is the Transverse Myelitis idiopathic?
Yes
Code G37.3
No
Associated with an infectious agent?
When to use each related code
| Description |
|---|
| Inflammation of spinal cord |
| Multiple Sclerosis |
| Neuromyelitis Optica |
Using G37.3 (unspecified) when a more specific TM type (e.g., idiopathic, recurrent) is documented, impacting reimbursement and data accuracy.
Overlooking and not coding relevant comorbidities (e.g., autoimmune diseases, infections) affecting severity and treatment, impacting DRG assignment.
Incomplete or incorrect coding of neurological deficits (e.g., paralysis, sensory loss) crucial for quality reporting and patient care evaluation.
Q: What are the most effective differential diagnosis strategies for Transverse Myelitis in adults presenting with acute myelopathy?
A: Differentiating Transverse Myelitis (TM) from other causes of acute myelopathy requires a multi-faceted approach. Clinicians should consider mimicking conditions such as multiple sclerosis, neuromyelitis optica spectrum disorder (NMOSD), acute disseminated encephalomyelitis (ADEM), spinal cord infarct, compressive myelopathy (e.g., due to disc herniation or epidural abscess), and infectious myelitis (e.g., viral, bacterial, or fungal). Crucially, the diagnostic process should involve a thorough neurological examination focusing on sensory and motor deficits, along with a detailed medical history including recent infections, vaccinations, or autoimmune conditions. MRI of the spinal cord with and without gadolinium is essential for visualizing lesions and assessing inflammation. Lumbar puncture for cerebrospinal fluid (CSF) analysis is also crucial for evaluating cell counts, protein levels, and the presence of oligoclonal bands or specific antibodies. Further investigations, such as serologic testing for infections and autoimmune markers (e.g., aquaporin-4 antibodies for NMOSD), may be necessary. Explore how incorporating evoked potentials can aid in evaluating the functional integrity of sensory and motor pathways. Consider implementing a standardized diagnostic algorithm to ensure a comprehensive evaluation and accurate diagnosis of TM. Learn more about the utility of advanced imaging techniques, like spinal cord diffusion tensor imaging, in differentiating TM from other myelopathies.
Q: How do I manage acute Transverse Myelitis flare-ups and provide optimal patient care in a hospital setting?
A: Managing acute Transverse Myelitis (TM) flare-ups necessitates a multidisciplinary approach with a focus on both symptom management and potential disease-modifying therapies. High-dose intravenous corticosteroids, such as methylprednisolone, are often the first-line treatment for acute inflammation. Plasma exchange (PLEX) may be considered for patients who do not respond adequately to steroids or have severe symptoms. In the hospital setting, supportive care is paramount, including pain management, bowel and bladder care, and respiratory support if necessary. Physical and occupational therapy should be initiated early to address functional limitations and promote recovery. Careful monitoring of neurological status and potential complications, such as respiratory distress or autonomic dysfunction, is crucial. Consider implementing a multidisciplinary team approach involving neurologists, physiatrists, rehabilitation specialists, and nurses to provide comprehensive patient care. Learn more about the latest evidence-based guidelines for managing acute TM flare-ups and long-term disease management strategies. Explore how integrating patient-reported outcome measures can enhance the assessment of treatment efficacy and personalize care.
Patient presents with complaints consistent with possible transverse myelitis (TM). Symptoms onset was reported as [suddengradual] [number] daysweeks prior to presentation and include [list specific symptoms e.g., sensory disturbances such as numbness, tingling, or burning sensations; motor weakness in the legs or arms; bowel or bladder dysfunction including incontinence or retention; back pain or band-like sensation around the chest or abdomen]. Neurological examination reveals [describe specific findings, e.g., hyperreflexia, sensory level to [specify dermatome], decreased motor strength [specify muscle groups and grade], positive Babinski sign]. Differential diagnoses considered include multiple sclerosis, neuromyelitis optica spectrum disorder (NMOSD), spinal cord infarction, Guillain-Barre syndrome, and compressive myelopathy. Ordered MRI of the thoracic spine with and without contrast to evaluate for inflammation and demyelination characteristic of transverse myelitis. Laboratory studies including complete blood count (CBC), comprehensive metabolic panel (CMP), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and vitamin B12 levels were ordered to rule out other etiologies. Initial treatment plan includes [specify e.g., high-dose intravenous corticosteroids (e.g., methylprednisolone) to reduce spinal cord inflammation, plasma exchange therapy if unresponsive to steroids, symptomatic management of pain, bowelbladder dysfunction, and spasticity with medications such as gabapentin, baclofen, and anticholinergics]. Patient education provided on transverse myelitis prognosis, potential complications, and the importance of follow-up care with neurology. Referral to physical therapy and occupational therapy for rehabilitation and functional recovery. ICD-10 code G37.3 (Transverse myelitis) is considered pending confirmation with imaging and laboratory results. Patient will be closely monitored for response to treatment and development of any new neurological deficits.