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How would you code this OA encounter?

  1. #1
    Jamaica, NY
    Default How would you code this OA encounter?
    Clearnace Sale

    Let's say someone is diagnosed with OA of both knees unspecified whether primary or secondary, would you code that as 715.36 or 715.89?

    I take it that 715.36 would mean: OA, localized, of just ONE knee since the fifth digit says "lower leg" not "lower legs". Or does "lower leg" include BOTH knees?

    The 715.89 code covers "multiple sites" but is not localized.

    So I'm a bit confused... does "lower leg" imply both sides or just one leg?

    Thanks for any help anyone can offer!

  2. #2
    Duluth, Minnesota
    from the link:

    Generalized osteoarthritis (code 715.0x or 715.8x) affects many joints, while localized osteoarthritis affects the joints of one site. Localized osteoarthritis can be further broken down into two other categories: primary and secondary. Primary osteoarthritis (715.1x), also known as idiopathic, affects joints of one site with no known cause. Secondary osteoarthritis (715.2x) affects a joint of one site and is due to some external or internal injury or disease. If the localized osteoarthritis is not specified as primary or secondary, code 715.3x is assigned. Bilateral involvement of the same site is still considered localized and is included in the fifth digit for the site. Code 715.9x is assigned when it is not specified as generalized or localized.

    I'd code the 715.36
    {that's my opinion on the posted matter}
    Donna, CPC, CPC-H

  3. #3
    Jamaica, NY
    Thanks Donna for the answer and the link. That pretty much explains it all..

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