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ICD-10 coding

Exit forum ID Forum Discussion ICD-10 coding

This topic contains 1 reply, has 2 voices, and was last updated by   Keith Puri, DC December 3, 2018 at 9:30 pm.

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    Matthew Ellerbrock

      Could someone shed some light on coding they use? I realized the coding is kind of a game we play with insurance companies, but I would really like my coding to match reality. However I am finding this in response to finding the right code for tendinosis dx of the left shoulder, you know…. from an expert:




      Default Tendinosis

      As it pertains to tendons, Rotator Cuff and in general for all other tendons, “Tendinosis” is one of the many terms used by Orthopedic Surgeons to indicate an “abnormality” of the tendon which they think is causing the patient’s problem. It is not a very specific term, but is probably most closely related to other terms such as Tendinitis or Tendinopathy. In other words, they really don’t know, but are blaming the clinical problem on a tendon or tendons. Radiologists often use this term in MRI Reports of the shoulder when they see “edema” of the tendon(s) but without being able to identify a tear, and implies “inflammation” of the tendon(s). Unfortunately, ICD-10 is very poor at coding these fairly synonymous terms. “Tendinitis” of the Rotator Cuff tendons is not even in the Descriptor in any of the M75 codes. Bicipital Tendinitis is specific. Calcific Tendinitis is specific, but is incorrectly described as “calcified bursa,” which it is not. The calcium is within the tendon. M75.5 _ is for “bursitis” of the shoulder, but doesn’t include the word “tendinitis.” From looking at other Forums regarding this issue, in which other Coders have put in input, M75.5 _, seems to be accepted on claims for “Rotator Cuff Tendinitis.” The next option would be M75.8 _, Other Shoulder Lesions, in which “Other” means “none of the above.”

      Hopefully, I hope this helps more than it adds to the confusion.

      Respectfully submitted, Alan Pechacek, M.D.Dont even ask about MSK adhesion…. unless you want to use adhesive capsulitis.  I think when I was at Carl’s office he had a code he used for adhesion.

      What coding do you all use besides the non specific ‘sprain-strain’ or ‘sydrome’ based codes?  I believe in trying my best to have congruency and if a patient looks at their coding and it says spr/strain but I told them adhesion….


      Keith Puri, DC

        Besides the pain, DJD, and intervertebral disc ICD-10 codes, I will list the dx code(s) for any peripheral nerve entrapment(s) if present (ex. G57.01 – Right sciatic nerve entrapment).

        For tendinopathies/tendinosis, I will use the enteropathies ICD-10 codes M76._ _ whenever possible. (ex. M76.61 – right achilles tendinosis).

        For myofascial adhesion, I use the ICD-10 code – M62.9

        Other codes I use less frequently include numbness (R20.2), cervicobrachial syndrome (M53.1), myalgia (other site M79.18, head/neck M79.12), muscle spasm of back (M62.830), and the headache and spinal stenosis codes .

        Unfortunately, with insurance, my diagnostic list is prioritized by pathology regardless of relevance. Myofascial adhesion (M62.9) is always listed just not at the top.

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