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Does anyone know under what circumstances 724.xx codes can be coded with 721.xx and 722.xx diagnosis codes. Can anyone refer me to some authoritative guidelines on this subject? Thanks.
Per the excludes comment following category 724 in ICD book, you would only be able to report codes in this category is they were NOT due to code ranges 733.00-733.09, 722.0-722.9 or 721.0-721.9.
Example, if the patient has low back pain due to lumbar spondylosis w/out myelopathy, you would only report the 721.3 code and would not separately report the 724.2. However, if the documentation specifically states the patient's low back pain is not due to the spondylosis but the symptom is due to an unknown reason, etc., then you could separately the lumbago in addition to the spondylosis code.
Yes, and unfortunately that information is rarely included in the op report. I would have to send back 99% of my op reports with a request for clarification. I thank you for your response.
A patient can have lumbar pain that is both discogenic in nature (722.xx, 724.xx) as well as from spondylosis/facet joints (721.3). The treatments for these two diagnoses are very different, however, so you should only need a code from one group to substantiate your cpt code.