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Symptoms vs. Disease

  1. Default Symptoms vs. Disease
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    Hi everyone,

    I do coding for a large physician group and after the physicians add their codes I review them for accuracy. I am having difficulty deciding when to remove symptoms that I believe are an inherent to a disease. For example: M47.892-Other spondylosis, cervical region with M54.2-Cervicalgia. I believe I would remove the cervicalgia but I am questioning myself. Does anyone have any advice as to what I can do to study this area of coding?

    Thank you

  2. #2
    I would agree that M54.2 is an inherent symptom of M47.892 Other Spondylosis; cervical region. If you look at the medical definition of spondylosis...

    Spondylosis, also known as arthrosis or osteoarthritis of the spine, is a term describing degeneration of the spinal column, usually due to aging and loss of fluid of the intervertebral discs. Degeneration can involve the intervertebral disc structure by weakening the collagen fibers of the annulus and decreasing the water content in the intervertebral disc, resulting in decreased disc height and increased risk for disk herniation. Spondylosis can also involve degeneration of the cartilage covering the facet joints and the formation of osteophytes as well as thickening and degeneration of the spinal ligaments resulting in loss of ligament strength

    It would appear that neck pain would be a part of the cervical region spondylosis.
    Chelle Johnson, CPC CPMA CDEO CEMC CPCO CPPM AAPC Fellow
    Billing/Coding/Credentialing/Auditing Coordinator

    20+ years experience in Medical Billing and Auditing

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