Orthopedic Coding Alert

Reader Questions:

Remember Code First Note on Arthropathy

Question: If a patient suffers from shoulder arthropathy as a result of sickle cell disease with crisis, how should you choose the appropriate ICD-10 code?

Missouri Subscriber

Answer: First, know that you’ll need a pair of diagnosis codes to represent these patient’s ailments. The first code you’ll need is for the sickle cell disease, not the arthropathy.

Then, you’ll need to check the notes for more specifics on both the diagnoses.

For the sickle cell disease, you’ll choose one of the following codes, depending on encounter specifics:

  • D57.00 (Hb-SS disease with crisis, unspecified)
  • D57.01 (Hb-SS disease with acute chest syndrome)
  • D57.02 (Hb-SS disease with splenic sequestration)
  • D57.03 (Hb-SS disease with cerebral vascular involvement)
  • D57.04 (Hb-SS disease with dactylitis)
  • D57.09 (Hb-SS disease with crisis with other specified complication)

Then, you can choose one of the following codes for the shoulder arthropathy:

  • M14.811 (Arthropathies in other specified diseases classified elsewhere, right shoulder)
  • M14.812 (Arthropathies in other specified diseases classified elsewhere, left shoulder)
  • M14.819 (Arthropathies in other specified diseases classified elsewhere, unspecified shoulder)

Explanation: When you look at the text below the header for the M14.8- (Arthropathies in other specified diseases classified elsewhere) code set, ICD-10 notes: “Code first underlying disease, such as:

  • “Amyloidosis (E85.-)
  • “Erythema multiforme (L51.-)
  • “Erythema nodosum (L52)
  • “Hemochromatosis (E83.11-)
  • “Hyperparathyroidism (E21.-)
  • “Hypothyroidism (E03.-)
  • “Sickle-cell disorders (D57.-)
  • “Thyrotoxicosis [hyperthyroidism] (E05.-)
  • “Whipple’s disease (K90.81).”