Conus medullaris syndrome

This code identifies a neurological disorder resulting from damage to the conus medullaris, the tapered end of the spinal cord. It typically presents with a combination of bilateral motor and sensory deficits in the lower extremities, bladder and bowel dysfunction, and saddle anesthesia. The condition often arises from acute compression or injury to this specific spinal cord segment.

Assign this code when documentation clearly indicates a diagnosis of conus medullaris syndrome. This diagnosis is supported by findings such as acute onset of bilateral leg weakness, urinary retention or incontinence, fecal incontinence, and sensory loss in the S3-S5 dermatomes. Imaging studies (e.g., MRI) confirming a lesion or compression at the T12-L2 vertebral level are crucial for definitive diagnosis.

• Differentiate carefully from cauda equina syndrome (G83.4), which involves nerve roots below the conus medullaris and presents with more asymmetric symptoms.
• Always code the underlying cause of the conus medullaris syndrome first, if known (e.g., spinal stenosis, tumor, trauma).
• Ensure documentation specifies "conus medullaris syndrome" and not just general spinal cord injury or dysfunction.