Palsy (spasm) of conjugate gaze

This code describes a neurological condition characterized by the inability to move both eyes together in a coordinated fashion in a specific direction. It indicates a paresis or spasm affecting the conjugate movement of the eyes, meaning the eyes fail to move synchronously when attempting to look left, right, up, or down. This can result in diplopia or nystagmus.

Assign this code when documentation specifies a diagnosis of palsy or spasm of conjugate gaze. This includes conditions like Parinaud's syndrome (dorsal midbrain syndrome) or other supranuclear gaze palsies affecting coordinated eye movements. Supporting documentation should clearly state the impairment of conjugate gaze.

• Differentiate from isolated extraocular muscle palsies (e.g., oculomotor, trochlear, abducens nerve palsies) which affect individual eye muscles rather than coordinated gaze.
• Ensure the documentation specifies "conjugate" gaze involvement to avoid miscoding.
• Consider sequencing this code as a primary diagnosis when it is the main reason for the encounter, or as a secondary diagnosis if it's a manifestation of an underlying neurological condition.