ICD-10-CM Cding Basics Chapter Specifics Chapter 13 Diseases f the Musculskeletal System and Cnnective Tissue Vilma Smith, LVN, CPC, CCS AHIMA Apprved ICD-10-CM/PCS Trainer Debra Bales, LVN, CPC 1 Rev. May 2015
ICD-10-CM Cnventins General rules fr use f the classificatin independent f the guidelines. Cnventins and instructins f the classificatin takes precedence ver guidelines. Incrprated within the Alphabetic Index and Tabular list as instructinal ntes. 2
Chapter 13: Diseases f the Musculskeletal System and Cnnective Tissue(M00-M99) Largest number f dcumentatin and cding changes Cnditins affecting the cervical spine nw require dcumenting the site as: Occipital-atlant-axial, r high cervical regin Mid-cervical regin Cervicthracic regin Cnditin affecting upper r lwer end f the bne at the jint is designated t the bne site nt the jint Bne, jint r muscle cnditins that are the result f a healed injury and are chrnic r recurrent cnditins are usually fund in the Musculskeletal System Chapter (13) Specific dcumentatin must be used t determine the differences f Acute traumatic vs Chrnic r Recurrent Musculskeletal cnditins : Acute traumatic cnditins are cded under Chapter 19 (Injury, Pisning, and Certain Other Cnsequences f External Causes) Any current, acute injury shuld be cded t the apprpriate injury cde frm Chapter 19. Many musculskeletal cnditins are results f a previus injury r trauma t a site, r are recurrent cnditins 3
Chapter 13: (cnt.) Expansin fr specified types f rheumatid arthritis, cmplicatins f lupus, rgan and reginal invlvements: Rheumatid Arthritis with rheumatid factr (M05.-) Felty s Syndrme (M05.0-) Rheumatid lung disease with rheumatid arthritis (M05.1-) Rheumatid vasculitis with rheumatid arthritis (M05.2-) Rheumatid heart disease with rheumatid arthritis (M05.3-) Rheumatid mypathy with rheumatid arthritis (M05.4-) Rheumatid plyneurpathy with rheumatid arthritis (M05.5-) Rheumatid arthritis with invlvement f ther rgans and systems (M05.6-) Rheumatid arthritis with rheumatid factr withut rgan r systems invlvement (M05.7-) Other Rheumatid arthritis with rheumatid factr (M05.8-) Rheumatid Arthritis withut rheumatid factr (M06.0-) Rheumatid Arthritis withut rheumatid factr, vertebrae (M06.08) Rheumatid Arthritis withut rheumatid factr, multiple sites (M06.09) Dcument site invlved - (Right r Left - Shulder, Elbw, Wrist, Hand, Hip, Knee, Ankle and Ft, Multiple Sites) 4
Chapter 13: (cnt.) Other Rheumatid Arthritis (M06.-) Adult-nset Still s disease (M06.1) Rheumatid bursitis (M06.2-) Dcument site invlved - (Right r Left Shulder, Elbw, Wrist, Hand, Hip, Knee, Ankle and Ft) Rheumatid bursitis, vertebrae (M06.28) Rheumatid bursitis, multiple sites (M06.29) Rheumatid ndule (M06.3-) Dcument site invlved - (Right r Left Shulder, Elbw, Wrist, Hand, Hip, Knee, Ankle and Ft) Rheumatid ndule, vertebrae (M06.28) Rheumatid ndule, multiple sites (M06.29) Other specified rheumatid Arthritis (M06.8-) Dcument site invlved - (Right r Left Shulder, Elbw, Wrist, Hand, Hip, Knee, Ankle and Ft) Other specified rheumatid Arthritis, vertebrae (M06.88) Other specified rheumatid Arthritis, multiple sites (M06.89) Rheumatid arthritis, unspecified (M06.9) 5
Chapter 13: (cnt.) Enterpathic Arthrpathies (M07.-) Dcument site invlved - (Right r Left Shulder, Elbw, Wrist, Hand, Hip, Knee, Ankle and Ft, Vertebrae, Multiple sites) Juvenile Arthritis (M08.-) Dcument site invlved - (Right r Left Shulder, Elbw, Wrist, Hand, Hip, Knee, Ankle and Ft, Vertebrae, Multiple sites) Unspecified juvenile rheumatid arthritis (M08.0) Juvenile rheumatid arthritis with systemic nset (M08.2-) Pauciarticular juvenile rheumatid arthritis (M08.4-) Other juvenile arthritis (M08.8-) Juvenile arthritis, unspecified (M08.9-) 6
Chapter 13: (cnt.) Systemic Lupus Erythematsus (SLE) M32.- Drug-induced systemic lupus erythematsus M32.0 Use additinal cde fr adverse effect, if applicable t identify drug (T36-T50 with fifth r sixth character 5) SLE with rgan r system invlvement (M32.1-) Endcarditis in Systemic Lupus Erythematsus M32.11 Pericarditis in Systemic Lupus Erythematsus M32.12 Lung invlvement in Systemic Lupus Erythematsus M32.13 Glmerular disease in Systemic Lupus Erythematsus M32.14 Tubul-interstitial nephrpathy in Systemic Lupus Erythematsus M32.15 Other frms f SLE (M32.8) Systemic Lupus Erythematsus (SLE), unspecified (M32.9) Systemic Sclersis [sclerderma] M34.- Prgressive systemic sclersis M34.0 CR(E)ST syndrme M34.1 Systemic sclersis induced by drug and chemical M34.2 Cde first pisning due t drug r txin, if applicable (T36-T65 with fifth r sixth character 1-4 r 6) Use additinal cde fr adverse effect, if applicable t identify drug (T36-T50 with fifth r sixth character 5) Other frms f systemic sclersis Systemic sclersis with lung invlvement M34.81 Systemic sclersis with mypathy M34.82 Systemic sclersis with plyneurpathy M34.83 7
Chapter 13: (cnt.) Seventh (7 th ) characters fr chrnic gut (M1A.-) 0 - withut tphus (tphi) 1 - with tphus (tphi) Example: Idipathic chrnic gut, right ankle and ft, withut tphus - M1A.0710 Seventh (7 th ) characters fr stress and pathlgical fracture (M80, M84.3 - M84.6) A - initial encunter fr fracture D - subsequent encunter fr fracture with rutine healing G - subsequent encunter fr fracture with delayed healing K - subsequent encunter fr fracture with nnunin P - subsequent encunter fr fracture with malunin S sequela Example: Age-related steprsis with current pathlgical fracture, vertebrae, initial encunter fr fracture - M80.08XA 8
Chapter 13: (cnt.) Intervertebral Disc Disrders Identify cnditin: Identify site: Disc disrder with myelpathy Disc disrder with radiculpathy Other disc displacement *use this fr the specified cnditin when n dcumentatin r either myelpathy r radiculpathy. Other disc degeneratin *use this fr the specified cnditin when n dcumentatin r either myelpathy r radiculpathy. Other disc disrders *use this fr the specified cnditin when n dcumentatin r either myelpathy r radiculpathy. Schmrl s ndes (M51.4-) Cervical (M50.-) High cervical regin Mid-cervical regin Cervicthracic regin Unspecified cervical regin Thracic regin (M51.-) Thraclumbar regin Lumbar regin (M51.-) Lumbsacral regin 9
Chapter 13: (cnt.) Lw Back Pain (M54.5)/Sciatica (M54.3-) Identify the lw back pain/sciatica With sciatica (M54.4-) Right side Left side Withut sciatica (M54.5) Osteprsis (M80.- ; M81.-) Identify steprsis as with r withut current pathlgical fracture Identify type /cause f steprsis Age-related Lcalized Bne depleting medicatins 10
Chapter 13: (cnt.) Osteprsis with current pathlgical fracture (M80.-) Dcument type f Osteprsis: Age-related steprsis Drug-induced Idipathic Osteprsis f disuse Pstphrectmy steprsis Pstsurgical malabsrptin Pst-traumatic steprsis Identify site f pathlgical fracture: Shulder Humerus Frearm Hand Femur Lwer Leg Ankle/ft Vertebra(e) Dcument episde f care (7 th character needed) refer t page 57 11