Intervertebral Disc Bulging

troupe327

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Hi there. I am a new coder, radiology diagnostic coding and I am looking at coding clinic to help me address how to code Intervertebral disc (IV Disc) disorders. I have a patient who has IV disc bulging at the cervical as well as the lumbar spine.

when I search "Bulging" in coding clinic, Fusion information comes up mentioning bulging disc with herniated disc in the same sentence but nothing beyond that.

I did some other research and found the American Journal of Neuro-Radiology on the nomenclature reporting which addresses some ideas about "disc bulging". it states,

"Translation of the disc nomenclature recommended here into ICD-9-CM codes presents relatively little difficulty. Discs characterized herein as "herniated" should be coded under 722.0, 722.10, 722.11, or 722.2. A disc described as "bulging" without further specification as to the cause of the bulging should not be coded as a displacement, but, like other observations of uncertain significance as 722.9 "other and unspecified disc disorder" or as 793.7, "nonspecific abnormal findings on radiographic examination" (musculoskeletal)."

http://www.asnr.org/spine_nomenclature/reporting.shtml

Any Thoughts on whether bulging is under herniated or disc disorder?

Leia
 

jmcpolin

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My thought on this has always been if a disc is buldging it is displaced because buldging is the disc coming expanding outside of the normal disc space. I may be wrong but I have always used the 722 codes for buldging disc.
 

jgf-CPC

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I have this info I have had for awhile from a description from workmans comp...it always came in handy for me:

Description: Displacement of a disc in the upper or lower back which may put pressure on the adjacent spinal nerve causing pain and sometimes sensory loss.
Other names: Herniated disc, Herniated nucleus pulposus (HNP), Disc bulge, Disc rupture, Disc protrusion.

Hope this helps!!!!
 
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