Primary osteoarthritis involving multiple joints icd 10

Osteoarthritis, also known as degenerative arthritis or degenerative joint disease, is a group of mechanical abnormalities involving degradation of joints, including articular cartilage and subchondral bone. Symptoms may include joint pain, tenderness, stiffness, locking, and sometimes an effusion. A variety of causes; such as hereditary, developmental, metabolic, and mechanical may initiate processes leading to loss of cartilage. When bone surfaces become less well protected by cartilage, bone may be exposed and damaged. As a result of decreased movement secondary to pain, regional muscles may atrophy, and ligaments may become more lax. Mechanical stress is suggested as the most common cause for OA, but overweight, loss of strength in the muscles supporting the joint, are also suggested as the among the other common causes of OA.

The disease may commonly affect the hands, feet, spine, and the weight bearing joints such as hip, and knee, but any joint of the body may be affected.

Basically osteoarthritis is divided into primary and secondary depending upon whether or not there is an associated underlying cause.

Primary osteoarthritis develops as a result of a degenerative process in joint cartilage due to aging. Whereas, secondary OA may result from a variety of underlying factors such as diabetes, congenital diseases of joint, inflammatory or metabolic diseases such as rheumatoid arthritis and gout, injury to joints, septic arthritis, obesity etc.

Coding in ICD-10-CM for osteoarthritis is somewhat similar and also different to ICD-9-CM. ICD-9-CM provides category 715 for coding of osteoarthritis including degenerative, hypertrophic and secondary to other factors with the fourth digit determines the type as OA generalized(0), OA localized primary(1), OA localized secondary(2), OA localized not specified as primary or secondary(3), OA more than one site but not specified as generalized(8), and OA unspecified as generalized or localized(9). The fifth digit in category identifies the site of OA without regard to the laterality.

ICD-10-CM provides codes for the coding osteoarthritis related encounters in the categories M15-M19. The first category M15 is used to assign the codes for generalized forms of osteoarthritis or arthritis where multiple joints are involved.

ICD-10-CM codes for localized forms of osteoarthritis are classified in much detail specificity than that of its predecessor. ICD-10-CM has reserved three categories M16-M18 for the more common form of localized osteoarthritis i.e., M16, OA of hip, M17, OA of knee and M18, OA of first carpometacarpal joint. In these categories the:

fourth digit "0" identifies the OA as bilateral primary
fourth digit "1" identifies the OA as unilateral primary
fourth digit "2" "3" "4" "5" "6" or "7" identifies the different forms of secondary OA(due to dysplasia/post-traumatic) of hip, knee and carpometacarpal joint

The fifth digit in the categories M16-M18 further specifies the laterality into unspecified, right, and left sided joint of the body.

ICD-10-CM category M19 is used for coding primary or secondary osteoarthritis of all the joints other than hip, knee and first carpometacarpal joint. Codes in this category are identified with:

Fourth digit "0" identifies the OA as primary of other joints
Fourth digit "1" and "2" as for post-traumatic and secondary respectively

The fifth digit in the category M19 identifies the different joints of the body and the sixth digit specifies the laterality as into unspecified joint, right, left sided joint.

Coding tips:

• Read the document carefully to identify the type of arthritis
• Check the joint(s) involved
• Determine the sub types of OA as primary or secondary
• Assign the code as specific as possible by choosing the code for the correct laterality

Documentation guidelines:

From a provider, expectations are much more than a simple abbreviated diagnosis "OA" or "arthropathy" from them in ICD-10-CM environment. There is a need to stress on making the habit of

• Describing the diagnostic statement in a more meaningful order
• Document the type and subtype of the osteoarthritis with site(s) involved
• Of course laterality is one of the major issues in ICD-10-Coding, better if described clearly the joint affected with the side involved such as bilateral, right or left.

Coding Tips:

• Follow the alphabetic index carefully then refer tabular list
• Search the description of MI as STEMI or NSTEMI in the medical record
• Identify the affected site and artery involved
• Determine the episode to be coded as initial MI or subsequent MI
• If Initial MI and Subsequent MI both present simultaneously follow the sequencing guidelines

Interesting Fact About ICD-10-CM

There are some instances where ICD-9-CM is much more specific than ICD-10-CM. Codes for unspecified arthropathies are more specific in ICD-9-CM than in ICD-10-CM. The reverse GEM of ICD-10-CM code M12.9 matches to ten (codes) possibilities in the subcategory 716.9 of ICD-9-CM.

As the countdown clock for ICD-10 implementation is moving fast a more determined effort from all stakeholders involved in the implementation process is a must to avoid the consequences of shoddy preparation for the mandate.

What is the ICD

What is the ICD

What is the ICD

How do you code multiple sites for osteoarthritis?