Orthopedic Coding Alert

Question: After a level-three evaluation and management (E/M) service for a new patient, the provider confirms a diagnosis of osteophyte in the patient’s shoulder. What is osteophyte, and how should we code this encounter?

Ohio Subscriber

 Answer: Osteophyte is no more than a clinical term for bone spurs. This patient had bone spurs in his shoulder.

On your 99203 (Office or other outpatient visit for the evaluation and management of a new patient, which requires these 3 key components: a detailed history; a detailed examination;

medical decision making of low complexity … ) claim, report one of the following ICD-10 codes depending on encounter specifics:

• M25.711 — Osteophyte, right shoulder
• M25.712 — … left shoulder
• M25.719 — … unspecified shoulder.