Transcript Chapter 11 Diseases of the Musculoskeletal System and Connective

Chapter 11
Coding for
Musculoskeletal System
and Connective Tissue
Diseases
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Musculoskeletal System and
Connective Tissue Diseases
• Musculoskeletal system and connective
tissue diseases are included in code
section 710 to 739 of chapter 13, in the
Disease Tabular of ICD-9-CM
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Musculoskeletal Disorders:
Arthritic Disorders
• Osteoarthritis (OA) (715.0-9X)
– Degenerative joint disease (DJD)
– Primary (idiopathic) versus secondary
(caused by injury or disease)
• Rheumatoid arthritis (714.0)
– Autoimmune disorder
• Gouty arthritis (274.00 – 274.03)
– Excessive uric acid levels
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Musculoskeletal Disorders:
Joint Derangements
• Chronic disorder
– Old injury
– Code 717.0-9
• Acute injury
– Current injury
– 836.0-6X
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Musculoskeletal Disorders:
Bone Fractures
•
Pathologic fractures
– Spontaneous fracture (non-traumatic) occurring from
weakened bone state due to disease
– Examples of diseases that may result in pathological
fractures : osteoporosis, osteopenia, bone metastases
•
Traumatic fractures
– Due to injury/trauma
– Example: football injury, motor vehicle collision, fall from
ladder
•
Stress fractures
- Due to repetitive application of force/overuse
- Example: running long distances
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Musculoskeletal Disorders:
Inflammatory Conditions
• Osteomyelitis (730.XX)
– Bone and bone marrow inflammation
– Caused by bacterial infection
• Necrotizing fasciitis (728.26)
– Infection of fibrous membrane that surrounds muscle
• Costochondritis (733.6)
– Inflammation of the cartilage between the sternum and
the ribs (usually resulting from over-strenous activity;
although non-coronary, chest pain similar to CAD
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Musculoskeletal Disorders:
Back and Spine Disorders
• Back pain NOS (724.5)
• Low back pain (724.2)
• Displacement of an intervertebral disk (i.e.,
slipped disk, ruptured disk, herniated nucleus
pulposis [HNP]), and spinal stenosis
– Surgical intervention
• Laminectomy (decompressive) (03.09)
• Laminectomy with diskectomy (code 80.51 for
diskectomy only; laminectomy is considered an operative
approach, and the code is omitted)
• Fusion procedure (81.0X)
• Spondylosis
– Degeneration of intervertebral disks (DJD of spine)
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Connective Tissue Diseases
• Systemic lupus erythematosus (SLE) (710.0)
– Autoimmune disorder that causes damage to
connective tissues (collagen) and may affect many
organs (i.e., “systemic” including joints, skin, heart,
kidneys, lungs).
• Systemic sclerosis (scleroderma) (710.1)
– A chronic progressive disease of the skin causing
hardening and shrinking of connective tissue that
may also affect internal organs (i.e., “systemic”) such
as the esophagus, heart, lungs, and kidneys. The
cause is unknown.
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