ICD-9 Code 333.1

Essential and other specified forms of tremor

  1. ICD-9 Index
  2. Chapter: 320–359
  3. Section: 330-337
  4. Block: 333 Other extrapyramidal disease and abnormal movement disorders
  5. 333.1 - Tremor NEC

Not Valid for Submission

333.1 is a legacy non-billable code used to specify a medical diagnosis of essential and other specified forms of tremor. This code was replaced on September 30, 2015 by its ICD-10 equivalent.

ICD-9: 333.1
Short Description:Tremor NEC
Long Description:Essential and other specified forms of tremor

Convert 333.1 to ICD-10

The following crosswalk between ICD-9 to ICD-10 is based based on the General Equivalence Mappings (GEMS) information:

  • G25.0 - Essential tremor
  • G25.1 - Drug-induced tremor
  • G25.2 - Other specified forms of tremor

Code Classification

  • Diseases of the nervous system (320–359)
    • Hereditary and degenerative diseases of the central nervous system (330-337)
      • 333 Other extrapyramidal disease and abnormal movement disorders

Information for Medical Professionals

Synonyms

  • Darkness tremor
  • Dystonic tremor
  • Early onset cerebellar ataxia with essential tremor
  • Essential tremor
  • Hereditary essential tremor
  • Intention tremor
  • Isolated facial tremor
  • Isolated head tremor
  • Isolated vocal tremor
  • Medication-induced postural tremor
  • Metallic tremor
  • On examination - intention tremor
  • On examination - tremor of tongue
  • On examination - tremor outstretched hands
  • Progressive cerebellar tremor
  • Saturnine tremor
  • Toxic tremor
  • Tremor opiophagorum

Index to Diseases and Injuries

References found for the code 333.1 in the Index of Diseases and Injuries:


Information for Patients


Tremor

What is a tremor?

A tremor is a rhythmic shaking movement in one or more parts of your body. It is involuntary, meaning that you cannot control it. This shaking happens because of muscle contractions.

A tremor is most often in your hands, but it could also affect your arms, head, vocal cords, trunk, and legs. It may come and go, or it may be constant. Tremor can happen on its own or be caused by another disorder.

What are the types of tremor?

There are several types of tremor, including:

  • Essential tremor, sometimes called benign essential tremor. This is the most common type. It usually affects your hands, but it can also affect your head, voice, tongue, legs, and trunk.
  • Parkinsonian tremor, which is a common symptom in people who have Parkinson's disease. It is usually affects one or both hands when they are at rest, but it can affect the chin, lips, face, and legs.
  • Dystonic tremor, which happens in people who have dystonia. Dystonia is a movement disorder in which you have involuntary muscle contractions. The contractions cause you to have twisting and repetitive movements. It can affect any muscle in the body.

What causes tremor?

Generally, tremor is caused by a problem in the deep parts of the brain that control movements. For most types, the cause is unknown. Some types are inherited and run in families. There can also be other causes, such as:

  • Neurologic disorders, including multiple sclerosis, Parkinson's disease, stroke, and traumatic brain injury
  • Certain medicines, such as asthma medicines, amphetamines, caffeine, corticosteroids, and medicines used for certain psychiatric and neurological disorders
  • Alcohol use disorder or alcohol withdrawal
  • Mercury poisoning
  • Hyperthyroidism (overactive thyroid)
  • Liver or kidney failure
  • Anxiety or panic

Who is at risk for tremor?

Anyone can get tremor, but it is most common in middle-aged and older adults. For certain types, having a family history raises your risk of getting it.

What are the symptoms of tremor?

Symptoms of tremor may include:

  • Rhythmic shaking in the hands, arms, head, legs, or torso
  • Shaky voice
  • Difficulty writing or drawing
  • Problems holding and controlling utensils, such as a spoon

How is tremor diagnosed?

Your health care provider may use many tools to make a diagnosis:

  • A medical history, which includes asking about your symptoms
  • A physical exam, which includes checking
    • Whether the tremor happens when the muscles are at rest or in action
    • The location of the tremor
    • How often you have the tremor and how strong it is
  • A neurological exam, including checking for
    • Problems with balance
    • Problems with speech
    • Increased muscle stiffness
  • Blood or urine tests to look for the cause
  • Imaging tests to help figure out if the cause is damage in your brain
  • Tests which check your abilities to do daily tasks such as handwriting and holding a fork or cup
  • An electromyogram, a test which measures involuntary muscle activity and how your muscles respond to nerve stimulation

What are the treatments for tremor?

There is no cure for most forms of tremor, but there are treatments to help manage symptoms. In some cases, the symptoms may be so mild that you do not need treatment.

Finding the right treatment depends on getting the right diagnosis of the cause. Tremor caused by another medical condition may get better or go away when you treat that condition. If your tremor is caused by a certain medicine, stopping that medicine usually makes the tremor go away.

Treatments for tremor where the cause is not found include:

  • Medicines. There are different medicines for the specific types of tremor. Another option is Botox injections, which can treat several different types.
  • Surgery may be used for severe cases that do not get better with medicines. The most common type is deep brain stimulation (DBS).
  • Physical, speech-language, and occupational therapy, which may help to control tremor and deal with the daily challenges caused by the tremor

If you find that caffeine and other stimulants trigger your tremors, it may be helpful to cut them from your diet.

NIH: National Institute of Neurological Disorders and Stroke


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ICD-9 Footnotes

General Equivalence Map Definitions
The ICD-9 and ICD-10 GEMs are used to facilitate linking between the diagnosis codes in ICD-9-CM and the new ICD-10-CM code set. The GEMs are the raw material from which providers, health information vendors and payers can derive specific applied mappings to meet their needs.

  • Approximate Flag - The approximate flag is on, indicating that the relationship between the code in the source system and the code in the target system is an approximate equivalent.
  • No Map Flag - The no map flag indicates that a code in the source system is not linked to any code in the target system.
  • Combination Flag - The combination flag indicates that more than one code in the target system is required to satisfy the full equivalent meaning of a code in the source system.

Index of Diseases and Injuries Definitions

  • And - The word "and" should be interpreted to mean either "and" or "or" when it appears in a title.
  • Code also note - A "code also" note instructs that two codes may be required to fully describe a condition, but this note does not provide sequencing direction.
  • Code first - Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology. For such conditions, the ICD-10-CM has a coding convention that requires the underlying condition be sequenced first followed by the manifestation. Wherever such a combination exists, there is a "use additional code" note at the etiology code, and a "code first" note at the manifestation code. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation.
  • Type 1 Excludes Notes - A type 1 Excludes note is a pure excludes note. It means "NOT CODED HERE!" An Excludes1 note indicates that the code excluded should never be used at the same time as the code above the Excludes1 note. An Excludes1 is used when two conditions cannot occur together, such as a congenital form versus an acquired form of the same condition.
  • Type 2 Excludes Notes - A type 2 Excludes note represents "Not included here". An excludes2 note indicates that the condition excluded is not part of the condition represented by the code, but a patient may have both conditions at the same time. When an Excludes2 note appears under a code, it is acceptable to use both the code and the excluded code together, when appropriate.
  • Includes Notes - This note appears immediately under a three character code title to further define, or give examples of, the content of the category.
  • Inclusion terms - List of terms is included under some codes. These terms are the conditions for which that code is to be used. The terms may be synonyms of the code title, or, in the case of "other specified" codes, the terms are a list of the various conditions assigned to that code. The inclusion terms are not necessarily exhaustive. Additional terms found only in the Alphabetic Index may also be assigned to a code.
  • NEC "Not elsewhere classifiable" - This abbreviation in the Alphabetic Index represents "other specified". When a specific code is not available for a condition, the Alphabetic Index directs the coder to the "other specified” code in the Tabular List.
  • NOS "Not otherwise specified" - This abbreviation is the equivalent of unspecified.
  • See - The "see" instruction following a main term in the Alphabetic Index indicates that another term should be referenced. It is necessary to go to the main term referenced with the "see" note to locate the correct code.
  • See Also - A "see also" instruction following a main term in the Alphabetic Index instructs that there is another main term that may also be referenced that may provide additional Alphabetic Index entries that may be useful. It is not necessary to follow the "see also" note when the original main term provides the necessary code.
  • 7th Characters - Certain ICD-10-CM categories have applicable 7th characters. The applicable 7th character is required for all codes within the category, or as the notes in the Tabular List instruct. The 7th character must always be the 7th character in the data field. If a code that requires a 7th character is not 6 characters, a placeholder X must be used to fill in the empty characters.
  • With - The word "with" should be interpreted to mean "associated with" or "due to" when it appears in a code title, the Alphabetic Index, or an instructional note in the Tabular List. The word "with" in the Alphabetic Index is sequenced immediately following the main term, not in alphabetical order.

Previous Code: 333.0

Related Codes

Next Code: 333.2