Intraspinal abscess and granuloma

This code signifies a localized collection of pus or an inflammatory mass within the spinal canal, but external to the spinal cord itself. This condition can compress the spinal cord or nerve roots, leading to neurological deficits.

Assign this code when documentation specifies an intraspinal abscess or granuloma that is not identified as tuberculous in origin. Supporting documentation will often include imaging reports (MRI, CT) confirming the location and nature of the lesion, along with clinical notes detailing symptoms such as back pain, weakness, or sensory changes.

• Ensure the documentation explicitly rules out a tuberculous etiology; otherwise, A17.81 would be the appropriate code.
• Look for specific anatomical locations (e.g., epidural, subdural) within the intraspinal space to confirm the diagnosis.
• Code any associated neurological deficits or underlying infections separately, if applicable.