Orthopedic Coding Alert

Code sets get major upgrade in new Dx book.

ICD-10 2021 will feature three major revisions to codes representing juvenile osteochondrosis (JO), and more than a dozen new codes to provide a more detailed picture of the patient’s injury via diagnosis code.

Condition defined: During her presentation “Juvenile Osteochondroses,” Nathalie Gaulier, MD, sports medicine physician at Cook Children’s Medical Center, defined the condition thusly:

• General term for disorders that affect one or more ossifi­cation centers in children.
• Encompasses traction apophysitis and avascular necrosis.
• Exact etiology unknown.
• Radiographic picture show pattern of fragmentation, collapse, sclerosis and reossification.

Treatments defined: According to Codify, JO “may cause a dull, nonspecific aching sensation in the joints of the affected area, especially upon application of pressure. Providers diagnose the condition based on personal history of symptoms, physical examination, and confirmation with X–ray. Treatment options are largely conservative, including rest for several days, followed if needed by application of a cast to restrict joint movement; rarely, surgical intervention may be required to remove abnormal bone fragments.”

Revisions Add Detail to JO Patients

The first JO-related revision is M92.50 (Juvenile osteochondrosis of tibia and fibula, unspecified leg), whose descriptor will change to M92.50 (Unspecified juvenile

osteochondrosis of tibia and fibula) in October. The M92.50- code set will also welcome these additions to its rolls:

• M92.501 (Unspecified juvenile osteochondrosis, right leg)
• M92.502 (Unspecified juvenile osteochondrosis, left leg)
• M92.503 (Unspecified juvenile osteochondrosis, bilateral leg)
• M92.509 (Unspecified juvenile osteochondrosis, unspecified leg)

The second revision is M92.51 (Juvenile osteochondrosis of tibia and fibula, right leg), whose descriptor will change to M92.51 (Juvenile osteochondrosis of proximal tibia) in October. The M92.51- codes will also get these additions in October:

• M92.511 (Juvenile osteochondrosis of proximal tibia, right leg)
• M92.512 (Juvenile osteochondrosis of proximal tibia, left leg)
• M92.513 (Juvenile osteochondrosis of proximal tibia, bilateral)
• M92.519 (Juvenile osteochondrosis of proximal tibia, unspecified leg)