ICD-9 Coding of DJD

rvalente

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I have recently started a new job working in the Home health arena. The other coder and I code DJD two different ways. Can someone please refer me to any official guidelines for further clarification as to how DJD should be coded?

If the DX states DJD Knee my co-worker uses the codes, 715.36 (local) I use 715.96 as unspecified.

I think perhaps my lack of understanding of the terms local/generalized/primary/secondary has me confused.

If anyone can weigh in with thoughts or resources, I'd sincerely appreciate it.

Thank you in advance,

Gina Valente, CPC
 

kevbshields

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We had this debate at my workplace. Your fellow coder probably came from the facility environment and you from the physician . . . just a stab.

I really don't have any resolution to offer, largely because it is a matter of subjectivity, in my opinion. Hopefully others will have something meaningful to add.

Good luck.
 

rthames052006

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Kevin,

It's funny you say that about physician coders/hospital coders I would code it as 715.96 also, and I too am a physician coder.

Roxanne Thames, CPC
 

judie

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Home Care Coding

Hi Gina,
I've been coding in home care for about 15 years. It's a whole differnt world of coding. It's nice to find other HC coders out there on this website.

Judie Jones CPC, COS-C
Carpentersville IL
 

Mary Baierl

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ICD-9 coding of DJD

I agree with using 715.96 for the knee. I am a physician coder also. I have been taught, if my physician does not specify "localized" then to default to the unspecified. I was taught to code "exactly" what the physician says. :( If he would not say the exact word "localized" but in his HPI and exam indicated no other OA or DJD was present, then that is localized enough for me.
 

sandrews724

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There is some good information regarding this subject on the AAOS website www.aaos.org--I found an article for Osteoarthritis of the Knee: State of Condition that defined primary and secondary and in a 2004 bulletin Margie Vaught is quoted as saying that when DJD is identified in one site but not identified as primary or secondary it should be coded as 715.3x

I use 715.3x when the physician is talking about a specific joint (knee, etc) if they do not specify then I use 715.9x or 715.8x depending on their dictation.

Thanks!
Sharon D CPC
 

kandigrl79

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I agree with Sharon D. I work in an orthopedic specialist's office and I always use 715.36 for DJD of the knee (provided the physician doesn't stipulate whether it is primary or secondary). 715.96 is saying that is "unspecified whether generalized or localized", 715.36 says "localized." My line of reasoning is that if the physician has already told you in the documentation that the DJD is in the knee, then it is in fact specified as being "localized" to the knee, hence my decision to use 715.36.
 

rthames052006

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Thanks Kandis for sheading some light on your reasoning for using the code you use I will querry my physician on this line of thought. Thanks.

Roxanne CPC
 

rvalente

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I have been taught, if my physician does not specify "localized" then to default to the unspecified. I was taught to code "exactly" what the physician says. :( If he would not say the exact word "localized" but in his HPI and exam indicated no other OA or DJD was present, then that is localized enough for me.
I was taught this way also.

Thank you all that contributed and for the link. I sincerely appreciate your opinions!

This forum is great!

Happy Coding :)
 

beev

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If anyone has been to a workshop taught by Margie Vaught, she says to use 715.3x.
 

lstaehler

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Coding DJD

I code DJD all the time in my line of work with orthopedic physicians. I was taught to use 715.16, etc. Hope this doesn't totally confuse you too much with all the other answers!
 

tbensonite

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Knee DJD

I tend to agree with Kandigrl79 on this. I too was taught that if the physician states "Knee DJD", it is localized and therefore codes to 715.36.
 
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