Eli's Rehab Report
How to Code an Unlisted Body Region
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Question: We had an athlete visit our office for therapy due to a strain of the gluteus maximus. I cannot find an injury code for that body part in ICD-9. Is there another valid code I can use? Answer: On the claim form, your best bet is to use the therapist's treatment or therapy diagnosis where allowed by state and local law -- this should serve as the diagnosis of why the patient requires skilled physical therapy services. For example, due to the strain of the gluteus maximus, does the patient have difficulty in walking? If so, you would code 719.7.
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Other possible therapy diagnoses could be abnormality of gait (781.2), or pain in the pelvic region and thigh (719.45). If you are looking for the medical diagnosis of strain of the gluteus maximus, you could code it as an unspecified site of sprain and strain (848.9).
Reader questions were answered by Rick Gawenda, PT, director of physical medicine and rehabilitation at Detroit Receiving Hospital.
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