Orthopedic Coding Alert

Question: What do "NEC" and "NOS" mean in ICD-9 coding? How should I choose between them?

Florida Subscriber

Answer: ICD-9 uses the abbreviations NEC and NOS to denote diagnoses "not elsewhere classified" and "not otherwise specified." Think of NEC as the book's fault. Your orthopedist provides specific findings, but the book does not list a specific code that describes the diagnosis.
 
On the other hand, consider NOS your physician's fault. Your orthopedist's documentation does not provide enough specific information to assign a more specific diagnosis code.
 
NEC codes are frequently highlighted in gray in the ICD-9 manual, and NOS codes are usually highlighted in yellow.
  
Here's an example of when you would use an NEC code: Your physician specifies spinal nerve root compression. You look in the 724.x category, Other and unspecified disorders of back, for the appropriate code. If 724.0-724.8 do not list the manifestation that the physician indicated, you should report 724.9 (Other unspecified back disorders).
But suppose the orthopedist notes "vertebrogenic syndrome." The physician doesn't specify what the syndrome is, so you should report 724.5 (Backache, unspecified). This code includes "vertebrogenic (pain) syndrome NOS."