Orthopedic Coding Alert

Don’t miss this Excludes1 note underneath M25.6.

If you’re used to reporting 719.5x right now, then you should know that your stiffness in joint NEC codes explode after October 1.

ICD-9-CM Codes: Currently, you should report these codes with:

• 719.50, Stiffness of joint not elsewhere classified involving unspecified site

• 719.51, Stiffness of joint not elsewhere classified involving shoulder region

• 719.52, Stiffness of joint not elsewhere classified involving upper arm

• 719.53, Stiffness of joint not elsewhere classified involving forearm

• 719.54, Stiffness of joint not elsewhere classified involving hand

• 719.55, Stiffness of joint not elsewhere classified involving pelvic region and thigh

• 719.56, Stiffness of joint not elsewhere classified involving lower leg

• 719.57, Stiffness of joint not elsewhere classified involving ankle and foot

• 719.58, Stiffness of joint not elsewhere classified involving other specified sites

• 719.59, Stiffness of joint not elsewhere classified involving multiple sites.

ICD-10-CM Codes: When your diagnosis system changes, you should look to the following options:

• M25.60, Stiffness of unspecified joint, not elsewhere classified

• M25.61-, Stiffness of shoulder, not elsewhere classified

M25.611, Stiffness of right shoulder, not elsewhere classified

M25.612, Stiffness of left shoulder, not elsewhere classified

M25.619, Stiffness of unspecified shoulder, not elsewhere classified

• M25.62-, Stiffness of elbow, not elsewhere classified

M25.621, Stiffness of right elbow, not elsewhere classified

M25.622, Stiffness of left elbow, not elsewhere classified

M25.629, Stiffness of unspecified elbow, not elsewhere classified

• M25.63-, Stiffness of wrist, not elsewhere classified

M25.631, Stiffness of right wrist, not elsewhere classified

M25.632, Stiffness of left wrist, not elsewhere classified

M25.639, Stiffness of unspecified wrist, not elsewhere classified

• M25.64-, Stiffness of hand, not elsewhere classified

M25.641, Stiffness of right hand, not elsewhere classified

M25.642, Stiffness of left hand, not elsewhere classified

M25.649, Stiffness of unspecified hand, not elsewhere classified

• M25.65-, Stiffness of hip, not elsewhere classified

M25.651, Stiffness of right hip, not elsewhere classified

M25.652, Stiffness of left hip, not elsewhere classified

M25.659, Stiffness of unspecified hip, not elsewhere classified

• M25.66-, Stiffness of knee, not elsewhere classified

M25.661, Stiffness of right knee, not elsewhere classified

M25.662, Stiffness of left knee, not elsewhere classified

M25.669, Stiffness of unspecified knee, not elsewhere classified

• M25.67-, Stiffness of ankle and foot, not elsewhere classified

M25.671, Stiffness of right ankle, not elsewhere classified

M25.672, Stiffness of left ankle, not elsewhere classified

M25.673, Stiffness of unspecified ankle, not elsewhere classified

M25.674, Stiffness of right foot, not elsewhere classified

M25.675, Stiffness of left foot, not elsewhere classified

M25.676, Stiffness of unspecified foot, not elsewhere classified.

When stiffness occurs in a patient’s joint, this suggests the patient may be suffering from an orthopedic related condition. You should report a patient’s symptom in the absence of a definitive diagnosis.

ICD-10-CM Change: Your stiffness in joint codes in ICD-9-CM (719.5x) are similar to your stiffness in joint codes in ICD-10-CM (M25.6-). The differences are that ICD-10-CM increases anatomical specificity by adding right and left options where applicable and also takes away “joint” from the descriptor. The codes specify “stiffness” of the anatomical region only.

Documentation: Your physician probably already documents the anatomical region where the patient complains of joint stiffness. After ICD-10 goes into effect, you will have a way to reflect this on your claim. However, remember to always code to the highest level of specificity.

Here is how you will locate these codes specific to joint pain in your Alphabetic Index:

Stiffness, joint NEC M25.60

• ankle M25.67-

• elbow M25.62-

• foot M25.67-

• hand M25.64-

• hip M25.65-

• knee M25.66-

• shoulder M25.61-

• wrist M25.63-

Coder tips: You will find an Excludes1 note underneath M25.6 (Stiffness of joint, not elsewhere classified) that prevents you from reporting any of these codes with ankylosis of joint (M24.6-) and contracture of joint (M24.5-).