Unspecified location? M19 codes are your clue.
Starting October 2013, when ICD-9 will change to ICD-10, physicians will need to more alert while documenting a patient who has osteoarthritis.
ICD-9 codes: Present diagnosis choices (e.g., 715.xx) indicate the arthritis location and whether it is primary or secondary to other conditions.
ICD-10 change: You’ll have to search several code families to find the best diagnosis:
- M15 (Polyosteoarthritis)
- M16 (Osteoarthritis of hip)
- M17 (Osteoarthritis of knee)
- M18 (Osteoarthritis of first carpometacarpal joint)
- M19 (Other and unspecified osteoarthritis).
Though each code is further divided into location, primary, and secondary in a way similar to the ICD-9 codes, they also at times have unilateral, bilateral, and posttraumatic indications. For instance, the exact diagnosis for a patient with primary OA of the right knee would be M17.11 (Unilateral primary osteoarthritis, right knee). The code would change to M17.12 for left knee or M17.0 for bilateral primary OA of the knee.
Documentation: To submit a complete and comprehensive diagnosis, the physician will need to expand documentation to include notes regarding unilateral, bilateral, and/or post-traumatic conditions. Keep an eye on key terms like “osteoarthritis,” “arthritis,” “arthrosis,” “DJD,” “arthropathy,” “post traumatic arthritis,” and “traumatic arthritis.”
ICD-10 Coding tips: You often find “unspecified” diagnoses in ICD-9 with codes representing more specific diagnoses for the same condition (as in, the .x9 choice in most ICD-9 categories). ICD-10 changes that by listing all “unspecified” diagnoses at the end of the condition category. For example, codes M19.90–M19.93 represent unspecified locations of osteoarthritis.
In addition, traumatic osteoarthritis is now more appropriately indexed and described as post-traumatic osteoarthritis, the true condition.