Home Health ICD-9/ICD-10 Alert

Published on Tue Jul 17, 2012 PDF

Question: We have a major discussion going on at our agency concerning the use of code 715.3x (Osteoarthrosis, localized, not specified whether primary or secondary) as opposed to 715.9x (Osetoartrosis, unspecified whether generalized or localized) when patients are diagnosed as having osteoarthritis when there is no mention of whether the OA is localized or generalized through the patient's body.

For example, we have a patient who had a total knee replacement (TKR). She had the joint replaced due to osteoarthritis. I see no reason why we should not use 715.96 in that example because nowhere is it stated that the OA is generalized or localized. But my co-worker suggests we use 715.36 (Osteoarthrosis, localized, not specified whether primary or secondary; lower leg). How should I code for this patient's OA?

California Subscriber

Answer: Your co-worker is correct. You can report 715.36 for this patient.

The definition of localized is that one joint is affected or the same joint is affected bilaterally. Because only one joint is affected in your example, the osteoarthritis is localized.