HCC 40 and coding questions

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Hello,
Is anyone having problems when Dr is using Arthritis of Lumbar and it is coding to M46.96 and that is HCC category 40?
Cherri
 

mamurph34

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Hcc 40

Funny you should mention this-we just had a provider say that not ALL arthritis is inflammatory. If you index under osteoarthritis, spine you are directed to see Spondylosis. This takes you to M47.----, which does not risk. So this may be a query to the provider if inflammatory isn't specified. (Arthritis NOS and osteoarthritis NOS both code to M19.90)
 
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I am also running into this situation right now. I don't have the Coding Clinic issue information at my fingertips but one in 2016 states in the United States "arthritis" is primarily meant to represent "osteoarthritis". So if the provider documents "lumbar arthritis" (with no other mention of an 'inflammatory' arthritis like the other diagnosis within the HCC 40 category) it would be indexed this way arthritis>meaning osteoarthritis>osteoarthritis>spine>see spondylosis which leads you to a diagnosis code in the M47 category. All arthritis has an inflammatory component but spondylosis (M47) is a very different condition than inflammatory spondylitis (M46). I'd love to hear other thoughts on this coding scenario.
 
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Hypertrophy of Ligamentum Flavum

Hello I would like to Know what is the appropriate code of the Hypertrophy of Ligamentum Flavum .
Hello I would like to Know what is the appropriate code of the Lumbar Facet Arthropathy .

In my opinion would be : M24.20 Disorder of Ligament -M24.28 Disorder of Ligament of Vertebra
In my opinion would be :M47.816 Lumbar Spondylosis

Thank you.
 
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