tci Outpatient Facility Coding Alert - 2013 Issue 6

Reader Question: Know Whether to Select 715, 716, or Another Dx for Knee Arthritis

Question:  Our physician wrote “knee pain” and “arthritis left knee” as a diagnosis. Would I use the 715 (Osteoarthrosis and allied disorders) or 716 (Other and unspecified arthropathies) category to code this? New Mexico Subscriber Answer:  “Knee pain” would be coded as 719.46 (Other and unspecified disorders of joint; pain in joint; lower leg). In general, arthritis (whether acute, chronic, or subacute) is classified as 716.9x, and arthritis in the knee would be coded 716.96 (Other and unspecified arthropathies; Arthropathy, unspecified; lower leg). Assuming the arthritis is a more definitive diagnosis of the...

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