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Coding tip: Understand the different degenerative disc diseases

Ambulatory Surgery Reimbursement Update, July 3, 2007

You might think that the term degenerative means that certain symptoms will worsen with age. The term actually applies to physical disc degeneration, however, and not worsening symptoms.

Degenerative disc disease (DDD) is not really a disease at all, but rather a degenerative condition, which can produce pain from a damaged disc. When a disc is damaged, there is minimal blood supply to the disc. Blood is what brings healing nutrients and oxygen to damaged structures in the body, so the spinal disc lacks any significant reparative powers of its own when damaged.

Unlike muscles, which have good blood supply, once a spinal disc is injured, it cannot repair itself. DDD is a natural part of aging for many people.

The pain associated with DDD is thought to stem from both inflammation and abnormal instability. This disease can occur at discs in the different spinal levels. Patients can develop cervical DDD, thoracic DDD, and lumbar DDD.

You should use the ICD-9 code 722.4 for the diagnosis of cervical DDD. Use code 722.51 for thoracic DDD, and use code 722.52 for lumbar DDD.

This tip is brought to you by Ellis Medical Consulting, Inc.

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