I am a coder for an ortho clinic. There seems to be some confusion between the doctors and PAs as to what the differences are between radulicopathy and myelopathy with regard to HNP or other disk disorders. Some docs will state pain, tingling, some numbness as myelopathy. Others will state those symptoms as radiculopathy. Keeping in mind that these diagnoses are being offered BEFORE diagnostic testing has been done. So my question is this: Would you clarify the differences of (symptoms and signs) radiculopathy vs. myelopathy for me, so that when I read the doctors documentation I can tell exactly if there is enough evidence to code "with myelopathy"? I've posed this question on a number of other forums and NO one has responded. Any help would be appreciated. JE in Colorado
Sometimes it can be difficult to distinguish between the two clinically by exam alone. Technically, a myelopathy means a problem with the spinal cord whereas a radiculopathy means a problem with the spinal nerve roots that just come out of the spinal cord. Both can be associated with pain, sensory symptoms, and weakness. One thing that can help localize is that both sides tend to be affected with a myelopathy whereas radiculopathy is one side only. But it's possible for the patients to have bilateral radiculopathies due ot one reason or another. Also, reflexes tend to be increased with myelopathy and decreased with radiculopathy.
These are by no means hard and fast rules. The entire clinical picture needs to be taken into account as well as the physical exam findings. Unfortunately, I don't this will help with your coding and should NOT be used as justification for one diagnosis over another.
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