Cracking the Code

Coding Cavernous Hemangioma

Cavernous hemangioma, also called cavernous angioma, venous malformation, or cavernoma, is a type of venous malformation due to endothelial dysmorphogenesis from a lesion that is present at the time of birth. A cavernoma in the brain is referred to as a cerebral cavernous malformation or CCM. Despite its designation as a hemangioma, a cavernous hemangioma is not a tumor as it does not display endothelial hyperplasia. The abnormal tissue causes a slowing of blood flow through the cavities, or “caverns”. The blood vessels do not form the necessary junctions with surrounding cells, and the structural support from the smooth muscle is hindered, causing leakage into the surrounding tissue. It is the leakage of blood, referred to as hemorrhage, that causes a variety of symptoms known to be associated with the condition.

The look of a cavernous hemangioma resembles a raspberry. It has blood-filled spaces, separated by connective tissue. Hemangiomas can range in size from a fraction of an inch to dime-sized or larger. The number and severity of symptoms depend on the size, location, and the number of hemangiomas. Symptoms vary from person to person. Some individuals don’t have any symptoms. Patients that do have symptoms can experience seizures, blurred vision, double vision or loss of vision, arm or leg weakness, unsteady walking, and headache to name a few. Approximately 20% of cavernous hemangiomas have a hereditary link.

Q: What is the ICD-10-CM code for a cavernous hemangioma in intracranial structures?
A: D18.02, Rationale: In the ICD-10-CM Alphabetic Index we want to look for Hemangioma/cavernous/intracranial which directs us to D18.02. Verification in the Tabular List confirms code selection.
Reference: FY 2023 ICD-10-CM Coding Book, Mayo Clinic, Mosby’s Medical Dictionary
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