Orthopedic Coding Alert

Question: Does the term "juvenile" in juvenile osteochondrosis (732.x) refer to the age of the patient or the stage of the disease? When the diagnosis is "osteochondral defect," which code should we report?

Delaware Subscriber Answer: Because most osteochondroses are diseases affecting the growth centers in children, they are referred to as "juvenile." Therefore, the term refers to diseases affecting children, and the codes are not appropriate for adults. If you see a patient with the adult form of this disease, you should report 732.7 (Osteochondritis dissecans) or 732.8 (Other specified forms of osteochondropathy).
 
When your physician uses the term "osteochondral defect," he is referring to a defect in the articular cartilage - the tough, elastic tissue that covers the ends of bones in joints. Unfortunately, CPT does not include an ICD-9 code that specifically describes this condition, so you should report 717.9 (Unspecified internal derangement of knee) for it.   - You Be the Coder and Reader Questions were reviewed by Heidi Stout, CPC, CCS-P, coding and reimbursement manager at University Orthopaedic Associates in New Brunswick, N.J.