Orthopedic Coding Alert

Question: What is the correct diagnosis for patients with degenerative joint disease of the knee? Minnesota Subscriber Answer: The answer depends on whether your physician documents the degenerative joint disease (DJD) as primary, secondary, or unspecified: • If you have documentation of localized primary disease, submit 715.16 (Osteoarthrosis, localized, primary; lower leg). • If your physician documents secondary disease, a diagnosis such as 715.2x (Osteoarthrosis, localized, secondary) might apply. • If you do not have documentation to support primary or secondary, report 715.36 (Osteoarthrosis, localized, not specified whether primary or secondary; lower leg). Although the joint disease usually is primary (715.16), if your physician doesn't specify "primary" in his diagnostic statement, you can't make that assumption. Instead, report 715.36. Bilateral tip: Don't miss the note with code family 715 explaining that, "Localized, in the subcategories below, includes bilateral involvement of the same site." If the patient exhibits degenerative joint disease [...]