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Thread: OS Acromiale

  1. #1

    Default OS Acromiale

    AAPC: Back to School
    Can someone please help me with the ICD 9 code for OS acromiale. Thank you!

  2. #2



    Simply put, it's shoulder impingement. (primary impingement - which can have different causes) ((primary impingement is usually do to degenerative changes and spurring in the joint area ))
    here's a web site with some basic info on it some of which I pasted below:

    Shoulder Impingement Syndromes:
    1)primary impingement
    2)secondary impingement
    3)subcoracoid impingement
    4)posterior-superior glenoid impingement

    Primary Impingement
    Etiologies of primary impingement:
    1)subacromial spurring
    2)subacromial fibrosis
    3)acromioclavicular (AC) joint spurring
    4)type II or III acromion
    5)os acromiale

    hope that helps...(guess I'd be coding the pain or cause of the pain, cause of the impingement)
    Donna, CPC, CPC-H

    Last edited by dmaec; 04-29-2009 at 03:20 PM.

  3. #3
    Join Date
    Apr 2007
    Billings, Mt

    Default Os acromion

    It is shoulder impingement which is 726.2

  4. #4
    Join Date
    Apr 2007

    Default Os acromiale vs shoulder impingement

    I would like to suggest that when shoulder impingemet (ICD-9 726.2) is stated to be due to a primary process like os acromiale, or if os acromiale is the sole problem without impingement, that a code for os acromiale should be reported.

    What is os acromiale:
    "Os acromiale, the joining of the acromion to the scapular spine by fibrocartilaginous tissue rather than bone, is an anatomic variant that has been reported in approximately 8% of the population worldwide."

    Since this is an anatomic variant (=born with it) and not secondary to some other condition like trauma, it should be reported using a code from the congenital anomaly section of ICD9. There is no specific code for this, so I suggest

    ICD-9 755.59: Other congenital anomaly of upper limb, including shoulder girdle

    If there are other documented conditions like impingement, then code them.

    BUT MOST OS ACROMIALE IS ASSYMPTOMATIC. So I strongly disagree with reporting os acromiale using the code for impingement, ICD-9 726.2, if there is no documentation of impingement.

    Scott Freathy, MD, CPC

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