Question Inflammatory spondylopathy

mreed63

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Looking for some help on this... Do conditions such DDD, DJD, spinal stenosis, facet arthropathy and similar conditions, fall under this category? It has been my understanding that an infectious process had to be at play, for this category to be applicable. The organizational coding guidelines provided, don't comment on this condition specifically, and no one has been able to provide a clear answer. Any clarification is welcome!

Many thanks.
 
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Looking for some help on this... Do conditions such DDD, DJD, spinal stenosis, facet arthropathy and similar conditions, fall under this category? It has been my understanding that an infectious process had to be at play, for this category to be applicable. The organizational coding guidelines provided, don't comment on this condition specifically, and no one has been able to provide a clear answer. Any clarification is welcome!

Many thanks.
I just coded one of these today. If you look up arthropathy in the alphabetic index, it says "see also Arthritis". If you then go to Arthritis, and then go to spine, it directs you to "see also spondylopathy, inflammatory." The codes in category M46.xx will map to HCC40. Spondylosis/DJD does not direct you to the inflammatory codes- they are just spondylosis, and then the location in the spine. Same for DDD and spinal stenosis. Spondylosis isn't inflammatory unless stated as such. You can always query the provider to be sure. Hope this makes sense! I reached out to my team lead for guidance on this and she was in agreement with me.
 

HCC12345

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Imaging should reflect an "inflammatory" process to code M46.xx. Otherwise you should code to Osteoarthritis in order to be accurate.
 
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I just coded one of these today. If you look up arthropathy in the alphabetic index, it says "see also Arthritis". If you then go to Arthritis, and then go to spine, it directs you to "see also spondylopathy, inflammatory." The codes in category M46.xx will map to HCC40. Spondylosis/DJD does not direct you to the inflammatory codes- they are just spondylosis, and then the location in the spine. Same for DDD and spinal stenosis. Spondylosis isn't inflammatory unless stated as such. You can always query the provider to be sure. Hope this makes sense! I reached out to my team lead for guidance on this and she was in agreement with me.
There is also a coding clinic with direction on this code selection
 
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There is also a coding clinic with direction on this code selection
Yes, after I posted this we were given some more information on this. We have been instructed to query when it isn't stated as inflammatory or not. We have some other direction on this, based on their treatment of the condition/resultant pain. It's one of those conditions that throws us for a loop. :)
 
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