Acute "S" code versus nontraumatic "M" code

karinquiterio

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There is some confusion in our orthopedic office as to when to assign an "S" code versus an "M" code if there is no injury but has only been going on for 4-6 months. Is "S" code only for an injury or is it okay to use the "S" code if it is a non-injury problem that has been going on for less than 6 months?

Thanks in advance!
 

CodingKing

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from the ICD-10 Guidelines;

Acute traumatic versus chronic or recurrent musculoskeletalconditions

Many musculoskeletal conditions are a result of previous injury or trauma to a site, or are recurrent conditions. Bone, joint or muscle conditions that are the result of a healed injury are usually found in chapter 13. Recurrent bone, joint or muscle conditions are also usually found in chapter 13. Any current, acute injury should be coded to the appropriate injury code from chapter 19 [S codes]. Chronic or recurrent conditions should generally be coded with a code from chapter 13 [M codes]. If it is difficult to determine from the documentation in the record which code is best to describe a condition, query the provider.
 
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