Radiology icd-9 shoulder & knee MRI

fisherdawnmarie

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I am unsure which diagnosis to select when there is no indication that the tear is a current injury, degenerative, or nontraumatic.

An example is: The patient presents with shoulder pain & decreased range of motion. The findings of the shoulder MRI are a very high grade partial tear of the supraspinatus tendon. Infraspinatus tendinosis.

Same thing with the Knee MRI. Patient presents with knee pain for several months. Findings are a high-grade partial tear of the posterior cruciate ligament and a complex tear of the posterior horn of the lateral meniscus.

In the past I have always used pain as the diagnosis because I could not determine if the tear was current or old but I am not sure if this is actually correct.
 

007CPC

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If it is substantiated code it

If the Radiologist substantiates tear of any tissue. Code it!
 

fisherdawnmarie

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What diagnosis would you use for the supraspinatus tear? If the only symptom is shoulder pain would you use 840.6, 726.10, or 727.61?
 

007CPC

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Corporate Coding

If the radiologist solely substantiates supraspinatus tear; code as an injury: 840.6, E928.9
I used these from a 2007 manual so……

Coding scenarios such as this one also depends on the severity of illness in relation to patient age.

Corporate coding is very ambiguous and requires the knowledge of a coder who currently works in the field; unlike healthcare coding. Allot of times insurance companies will pay for the code “pain in extremity” even though that coding choice doesn't signify to the highest specificity. If you feel comfortable with the answer I have provided-It was a pleasure to help. If you feel you need more guidance to code along what the insurance companies want you to code, I refer all coders in the radiography specialty to coders -Forum name: kevinbShields or abishard. These coders have contemporary experience with this specialty.
 
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