Orthopedic Coding Alert

Considering the many changes to CPT 2002, orthopedic coders may be relieved to know that ICD-9 has basically stayed the same. A Summary of Code Changes in ICD-9 2002 lists all revisions and additions, but a few of those pertinent to orthopedics are mentioned here.
 
Most notable for orthopedic surgeons is the addition of 840.7 (super glenoid labrum lesion [SLAP]) in the 840 series, sprains and strains of the shoulder and upper arm. This will pair nicely with the new CPT code for SLAP lesion repair 29807 (arthroscopy, shoulder, surgical; repair of SLAP lesion). 
 
The new code 718.7x (developmental dislocation of joint) requires a fifth digit to describe the joint site, e.g., 718.71 (developmental dislocation of joint, shoulder region).
 
There are three new codes for stress fractures, which had previously been reported with 733.1x (pathologic fracture). An exclusion note has been added to 733.1 to direct coders to the new stress fracture series.
 
733.93 stress fracture of tibia or fibula.
 
733.94 stress fracture of the metatarsals.
 
733.95 stress fracture of other bone.

 
A few new E codes (external causes of injury or poisoning) may be of use to orthopedic coders, specifically E917.5 (injury in sports with subsequent fall) and E917.6 (injury caused by a crowd, by collective fear or panic with subsequent fall).