I was taught that the doctor must distinguish between localized and generalized in his/her documentation to code it as such. If you look at your ICD-9 book, code 715.9X states "Osteoarthrosis, unspecified whether generalized or localized". We've all heard the saying that coders should never assume. So, to me, coding localized DJD for documention stating "OA of the right knee" is assuming that it really is localized, when it could have just been that the doctor was focusing on the right knee on that DOS because the patient brought up the fact that they were having pain or whatever. There would be no need for the "unspecified whether generalized or localized" code if we were supposed to use the localized code in the presence of documentation stating OA of [insert site here].
So as for me, until they decide to delete code 715.9X, I will let the doctor's documentation distinguish between localized, generalized, and NOS OA.
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