Health Information Management

Q&A: Coding patellofemoral chondrosis in ICD-9-CM and ICD-10-CM

HIM Connection, June 21, 2011

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Q: How should I report patellofemoral chondrosis?

A: Patellofemoral chondrosis “is the softening or loss of smooth cartilage, most frequently that which covers the back of the kneecap,” according to the Patellofemoral Foundation. (For more information, visit www.patellofemoral.org. Click on Patellofemoral Online Education, and then select Arthritis [PF Chondrosis].)
 
Neither Coding Clinic nor the ICD-9-CM index list patellofemoral chondrosis. Therefore, you must query the physician and request an alternative diagnosis. You may need to request more than one diagnosis if the patellar and femoral components of this term require separate codes.
 
Note that ICD-9-CM code 717.7 (chondromalacia of the patella) includes these subterms:
  • Chondromalacia patellae
  • Degeneration [softening] of articular cartilage of patella
Therefore, patellofemoral chondrosis could be a potential alternative diagnosis in a multiple-choice query to a physician. The query should also request clarification regarding the femoral portion of this diagnosis.
 
Even with its added specificity, ICD-10-CM, at the present time does not have entry in the Alphabetic index for chondrosis, patellofemoral. However, there are some categorical changes to this section of the musculoskeletal chapter from ICD-9-CM.
 
In ICD-9-CM, code 717.7 is located in the subcategory of internal derangement of the knee. In ICD-10-CM, the equivalent of this code is in the more specific subcategory of disorder of the patella (M22.-). Furthermore, an added subcategory under M22 specifically identifies patellofemoral disorders. Although it’s not clear in the Alphabetic index, the M22.2- series may contain the more specific code. It is indexed under disorder, patellofemoral. Note the following ICD-10-CM codes:
  • M22.2x1 (patellofemoral disorders, right knee)
  • M22.2x2 (patellofemoral disorders, left knee)
  • M22.2x9 (patellofemora disorders, unspecified knee)
Editor’s Note: Jean Stone, RHIT, CCS, coding manager at Lucile Packard Children’s Hospital at Stanford in Palo Alto, CA, and Shannon McCall, RHIA, CCS, CCS-P, CPC, CPC-I, CEMC, CCDS, director of HIM and coding at HCPro, Inc., in Danvers, MA, answered this question in the June 7 issue of JustCoding.



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