Chapter 13: Musculoskeletal System and Connective Tissue (M00–M99) Flashcards
(17 cards)
What do most Chapter 13 codes specify?
The body part affected (like a bone, joint, or muscle) and the side (right, left, or unspecified).
What if there’s no code for multiple sites?
Assign separate codes for each affected area.
What do you do if a condition affects multiple areas, and there’s a code for “multiple sites”?
Use the “multiple sites” code if available.
Where do you code acute injuries like fractures or sprains?
In Chapter 19 (Injury codes).
True or False: For conditions like avascular necrosis or osteoporosis, you code the joint, even if the disease affects the nearby bone.
False – You code the bone, even if it’s near a joint.
Where do you code chronic or long-term musculoskeletal problems?
In Chapter 13.
What should you do if the documentation doesn’t say if it’s an acute or chronic issue?
Ask the provider for clarification.
What is a pathologic fracture?
A fracture caused by weakened bones (like from osteoporosis or cancer), not trauma.
What seventh characters are used for pathologic fractures?
A = Active treatment (surgery, ER care, casting, etc.)
D = Healing phase (routine care during recovery)
Other letters = For complications like malunion, nonunion, or sequelae
Is osteoporosis a localized or a systemic disease?
It’s a systemic disease – it affects the whole skeleton.
What if the patient is being treated for a complication after surgery for a pathologic fracture?
Use a surgical complication code, not the regular fracture code with a seventh character.
What code should be added if the patient has a history of fractures from osteoporosis?
Add Z87.310 (history of osteoporotic fracture).
When do you use M81 codes?
When the patient has osteoporosis without a current fracture.
When do you use M80 codes?
When the patient has osteoporosis with a current fracture caused by weakened bones.
True or False: If the patient fell, you can’t use an osteoporosis fracture code.
False – If the fall was minor and wouldn’t break a healthy bone, it’s still considered an osteoporotic fracture.
Do M80 codes describe the location of osteoporosis or the fracture?
They describe the location of the fracture, not the osteoporosis itself.
Where is the coding guidance for Multisystem Inflammatory Syndrome found?
In Section I.C.1.g.1.l of the guidelines.
