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840.4 vs 727.61

  1. #1
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    Question 840.4 vs 727.61
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    Rotator cuff tear, if documentation does not say weather its tramatic or not tramatic which do I default too? Am I missing something in ICD-9 (not degenerative)

    THANKS :-D

  2. Default 840.4 vs 727.61
    I would look at the other diagnosis because 727.61 would be a condition of Rheumatism. If there is no indication of rheumatism in the patient's record, I would use the Strain code 840.4.

    Hope this helps.

  3. #3
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    Quote Originally Posted by TonyaMichelle View Post
    I would look at the other diagnosis because 727.61 would be a condition of Rheumatism. If there is no indication of rheumatism in the patient's record, I would use the Strain code 840.4.

    Hope this helps.

    I'm sorry where did you see in ICD that 727.61 is a condition of Rheumatism?
    Volume 2 index under tear>rotator cuff> it says tramatic, current injury, degenerative & non-tramatic. And when going to Volume 1 and look up tramatic & non tramatic, i dont see anything about it being a condition of Rhematism??

  4. #4
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    Default
    Quote Originally Posted by RadMedCoder View Post
    I'm sorry where did you see in ICD that 727.61 is a condition of Rheumatism?
    Volume 2 index under tear>rotator cuff> it says tramatic, current injury, degenerative & non-tramatic. And when going to Volume 1 and look up tramatic & non tramatic, i dont see anything about it being a condition of Rhematism??
    The chapter heading is "Rheumatism, Excluding the back (725-729)"...have to look a couple pages back to see it.
    Meagan Strauss, CPC, CEMC
    Coding Coordinator
    The NeuroMedical Center
    Baton Rouge, LA

  5. #5
    Location
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    Default
    Rheumatism or rheumatic disorder is a non-specific term for medical problems affecting the joints and connective tissue.

    Guess I'm still confused?

  6. Default 840.4 vs 727.61
    Don't worry coding can be confusing.

    The rotator cuff is a component of the shoulder joint and if it is torn it becomes a medical problem of the shoulder joint.

  7. Default
    My coworkers & I don't always code the same things exactly the same way & we agree that one way or the other may not be wrong ... it's a matter of interpretation. I personally do not use 727.61 often because the words complete rupture suggest to me that all 4 tendons were torn, which isn't usually the case. If the tearing is not a current condition 726.10 may be an option.

  8. Default
    With a complete rotator cuff tear there could be one or more tendons involved, so I still stand by 727.61 if the patients record reflects that diagnosis. See definition of complete rotator cuff tears below.

    "Full-thickness rotator cuff tears, also called complete rotator cuff tears, occur when one or more tendons become completely detached from the bone. This condition requires surgical intervention to reattach the tendon(s) and clean out any bone spurs. A specific protocol of progressive exercises must take place after surgery to ensure the success of the repair and to help the person regain shoulder function."

    Hope this helps...

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