Home Health ICD-9/ICD-10 Alert

Reader Questions:

716.16/905.4: Avoid V Code for Arthritis with Fracture History

Question:

Our patient has early post traumatic arthritis and early degenerative joint disease of the knee. She also has a history of proximal tibia fracture. What is the correct arthritis diagnosis code?

Maine Subscriber

Answer:

Your best choices are 716.16 (Traumatic arthropathy; lower leg) to describe the patient's current condition and 905.4 (Late effect of fracture of lower extremities) to explain the underlying cause.

Avoid: Another option at first glance is V15.51 (Personal history of injury; traumatic fracture). Don't report it, however, because V15.51 is a status code to note the patient is at higher risk for a re-fracture. The combination of 716.16 and 905.4 gives a clearer picture of the situation.

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