Wiki Rheumatoid Arthritis

[Evelyn Kim]

I need some help with a confusion over the proper coding for Rheumatoid Arthritis that has no manifestations. In the ICD-9-CM manual under 714.0 there is a note to "use additional code to identify manifestation as : myopathy (359.6) or polyneuropathy (357.1)"; We are having a discussion at work about weather this means that there has to be one of these two in order to code RA or if it is a case of where it is applicable (if the manifestation exists) code it.

We are confused as we have never had this come up before.

any guidance or advice would be appericated.

 

[ollielooya]

The directions to "use additional code to identify manifestation, as: myopathy (359.6) polyneuropathy (357.1)" had me stumped to as one of our physicians used the same diagnosis 714.0 alone. In researching the offical conventions guidelines and the "Instructional Notes" found this.....you probably already know it, but it's good to always get a refresher (just like I did!):

"The instructional notes appear in red type in the Tabular list. Use additional code: This instruction signals the coder that an additional code should be used IF the information is available to provide a more complete picture of that diagnosis. "

So, IF that information is not available, it's my understanding that the solo diagnosis would suffice? That's my take on it.

 

[Evelyn Kim]

Suzanne,
That was what we were thinking too, but even the instructional note is a bit vague about wheather 714.0 can stand alone. Although not everyone who has RA has myopathy or polyneuropathy. So still not sure.

If there are any Orthopaedic coders out there who can shed some light please chime in.

 

[chaimz]

I agree with Suzanne.

Just code what's on the SOAP sheet. The doctor needs to learn to be more specific within the encounters if he/she wants a higher reimbursement rate.