Chandra: A: For the ICD-10 for osteoarthritis, the guidelines actually state that you should
use the multiple osteoarthritis code unless the specific codes are more appropriate for
the circumstantial coding, and basically it comes down to the payer rules.
If you’re seeing a patient simply to manage their osteoarthritis and they’ve got osteoarthritis
in multiple joints, maybe they got in their left shoulder, their right shoulder, their
left elbow and their left hip.
Most providers are going to report that with a multiple osteoarthritis
code.
The times that you would break into the specific joint and laterality would be when you’re
trying to prove or substantiate medical necessity for certain things, like if you were evaluating
a patient or planning to do a hip replacement on that same patient, they may have osteoarthritis
and all these different joints but you’re focused on the hip joint, specifically the
left hip joint.
So, your claim should have the specific code to say, “Specifically we’re dealing with
osteoarthritis of the left hip,” then you could add additional
codes, say “they also have it here, here, and here,” but for our purposes we want
that specificity.
That’s really the only time that she usually going to come into play, it all comes down
to payment, unfortunately.
Laureen: Is this the guideline?
Alicia: M15 – M19 are the codes that we’re looking at, that’s it.
Chandra: Yeah.
Usually there’s a multiple sites option, for categories where there’s no multiple
site, code should be used to indicate the different sites involved.
Alicia: M15.3 secondary multiple arthritis?
Chandra: That’s secondary.
When you’re talking M15, remember secondary is the result of something else.
These are more than likely, I think they’re M19s if I remember correctly.
Alicia: Yeah, I was there…
Laureen: I just wanted to share this is how you can be your own consultant and basically
answer your own questions.
Not that we don’t love doing it, but this is what I typed in as they were talking “ICD-10
guidelines site and laterality” boom!
It brought me right here, I opened it up.
I typed in “site and laterality” and it brought me right to it.
Google is your friend, double check it, but when you have
questions like that, that’s how we start all of these questions and then we try double
check each other.
Chandra: Especially when you have ICD-10 questions.
My colleagues and my…