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Arthritis Dx HELP

  1. Default Arthritis Dx HELP
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    Pt is a coming from workers comp. She got approved with the dx of 716.56(Polyarthritis;5 or more joints simultaneously). Doctors dictation only states tricompartmental osteoarthritis and more moderate changes of the femoral tibial joint space. For tricompartmental osteoartritis I used 715.36, but WC is denying the claim.

    Did I use the right dx? I believe I did, but Im starting to doubt myself and I would like some others input about it before I go talk to the doctor about this.


  2. #2
    Greater Pittsburgh
    715.3X is for degenerative, I would have used 716.X for traumatic.because it is Workers Comp., verify with the Dr. that it is from the pt's. injury.
    jdemar, CPC, CMA

  3. Default
    If you have a WC for USPO or DOD, you MUST use the "accepted" diagnosis whether you
    agree with it or not if you wish to get paid. Government WC is a totally different breed of cat and the "accepted" diagnosis, as long as it is the same body part, and somwhat close, must be used. Strange, but TRUE !!

  4. #4
    Greater Pittsburgh
    I do know that, but shouldn't you complete and submit a C-9 form to Ohio W Comp. and have it corrected to reflect the correct diagnosis?
    jdemar, CPC, CMA

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