Wiki Lumbar Facet Arthropathy

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Code: L40.50
Code Name: ICD-10 Code for Arthropathic psoriasis, unspecified
Block: Papulosquamous disorders (L40-L45)
Details: Arthropathic psoriasis, unspecified
Guidelines: Diseases of the skin and subcutaneous tissue (L00-L99)
Excludes 2: certain conditions originating in the perinatal period (P04-P96)
certain infectious and parasitic diseases (A00-B99)
complications of pregnancy, childbirth and the puerperium (O00-O9A)
congenital malformations, deformations, and chromosomal abnormalities (Q00-Q99)
endocrine, nutritional and metabolic diseases (E00-E88)
lipomelanotic reticulosis (I89.8)
neoplasms (C00-D49)
symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)
systemic connective tissue disorders (M30-M36)
viral warts (B07.-)
For more details, visit: https://coder.aapc.com/icd-10-codes/L40.50

coderguy1939

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Can anyone out there give me some insights on how they are coding this diagnosis. Arthropathy is the key word for me which only means joint disease. I'm leaning towards 724.9. Thanks.
 

coderguy1939

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I have in the past used 716.98 Unspecified Arthropathies and the 5th digit per AHA Coding Clinic is for the spine. Guess I'll go back to that. Thanks.
 

marvelh

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Alphabetic index for arthropathy directs to see also arthritis...

listing for Arthritis, cervical directs to see also Spondylosis, cervical and code 721.3

listing for Arthritis, thoracic directs to see also Spondylosis, thoracic and code 721.2

listing for Arthritis, lumbar directs to see also Spondylosis, lumbar and code 721.3

listing for Arthritis, spine directs to 721.9

Spondylosis is defined as degenerative changes in the spinal joint. Under 716.9 exchangeable terms is also arthritis and also under the Spondylosis codes 721. includes the exchangeable terms arthritis, osteoarthritis and spondylarthritis.

Many payer policies that have IDC limitation for facet joint injection / destruction include the spondylosis diagnosis codes rather than the other and unspecified arthropathy diagnosis codes.

If provider is using term facet arthropathy, it is probably best to check to see if he/she is using the term interchangeably with spondylosis and report the more specified ICD-9 code. You may then also want to include this in the provider's compliance plan noting the interchangeable use of terms.
 

LINZSEY

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Shouldn't there be a difference in the disease process (arthropathy, osteoarthritis, rheumatoid arthritis, psoriatic athropathy, etc.) that would prompt the selection of one code set over the other? There are over 100 kinds of arthritis and manifestions, and not every kind of arthropathy can be categorized according to ICD9.

The tendency of the physicians to use these terms interchangably can be very confusing to the coder, since the courses of each connective tissue disease processes are variable according to each patient. The medical interventions are very different depending on which process is going on, and the stage of it's severity.

It is never out of season to keep an open line of communication between the coder and the physician/providers. We are not able to correctly code an encounter without clarity, with the recent surge of advancement in the rheumatology arena. We can show an appreciation of the advancement in this field by asking our providers to educate us in these disease processes.

We can always ask the doc to help us know the difference between the arthropathies so that we can capture the patient's diagnoses correctly.

Just my opinion, of course
 

tauros0427

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We were using 724.8 for facet syndrome but another coder in the office did raise a question that led us to start using 721.3
 

oyboutj

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From the Tabular Section

Under the first header for ICD-9 Section 13. Diseases of the Musculoskeletal System and Connective Tissue, under where it says Arthropathies and Related Disorders (710-719), it states

"Excludes disorders of spine (720.0-724.9)"

The code range 710-719 is not used for spinal disorders.

Arthropathies of the spine have their own section in ICD9, called:

"Dorsopathies (720-724)"
 

dwaldman

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I had searched "facet arthropathy" in the past and saw the response from MarvelH in this thread and always used that as the coding guidance for facet arthropathy.
 
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