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How are Sesamoiditis, Capsulitis, and Bunionette now Coded?
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When discussing diagnoses (ICD-10-CM), there are important topics that need to be covered:
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You need to investigate the mapping from ICD-9-CM to ICD-10-CM first.
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Once you have options, you must then look at the tabular section to obtain diagnosis codes that can be used for these examples.
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There are resources that you should use to make sure the diagnosis codes are the most accurate.
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Where do I find sesamoiditis then? Typically you look in the index for a diagnosis, you did it in ICD-9-CM and you can do it in ICD-10-CM. The mapping from ICD-9-CM to ICD-10-CM provides an option in ICD-10-CM tabular. Once you have either looked at the index or the mapping, my suggestion is to then look at the tabular section to make sure the diagnosis fits. Starting with the ICD-9-CM, you probably previously used 733.99. Let’s look at the mapping. Understand these are all the actual possibilities associated with this one code if you only look at mapping:
- Other disorders of continuity of bone, right ankle and foot M84.871
- Other disorders of continuity of bone, left ankle and foot M84.872
- Skeletal fluorosis, right ankle and foot M85.171
- Skeletal fluorosis, left ankle and foot M85.172
- Other specified disorders of bone density and structure, right ankle and foot M85.871
- Other specified disorders of bone density and structure, left ankle and foot M85.872
- Other disorders of bone development and growth, right ankle and foot M89.271
- Other disorders of bone development and growth, left ankle and foot M89.272
- Hypertrophy of bone, right ankle and foot M89.371
- Hypertrophy of bone, left ankle and foot M89.372
- Osteolysis, right ankle and foot M89.571
- Osteolysis, left ankle and foot M89.572
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The consensus of the top coding professionals I have had conversations feel ICD-9-CM - 733.99 Sesamoiditis = ICD-10-CM-M77.8 is the best one to use. Other enthesopathies, not elsewhere classified (NEC). Note the ones that the mapping provided. This is why it is important to attend webinars, seminars and read articles such as these.
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Where to find capsulitis then? Using the resource mapping from ICD-9-CM to ICD-10-CM provides an option in ICD-10-CM tabular. My suggestion is to then look at the tabular section to make sure the diagnosis fits. Starting with ICD-9-CM 726.90 Capsulitis, not otherwise specified we find it maps to M77.9 Enthesopathy, unspecified. It has an “Inclusion Term” Capsulitis NOS. But we can drill into the tabular section more specifically to come to the more specific foot option in ICD-10-CM. Other enthesopathy of foot (Bone Spur, Bursitis, Capsulitis, Tendinitis) for the right M77.51 and for the left M77.52.
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Where to find bunionette then? Use the resource mapping from ICD-9-CM to ICD-10-CM provides an option in ICD-10-CM tabular. My suggestion is look at the tabular section to make sure the diagnosis fits. In this example, start with ICD-9-CM code 727.1, the code for Bunionette (acquired). The problem is the mapping for this goes to Hallux valgus (acquired), unspecified foot M20.10. Clearly this is not a possibility as Hallux valgus is a 1st MTPJ deformity and NOT a 5th metatarsal deformity. So, you must go to the tabular section and select an option as the mapping is incorrect. The best recommendation is to use either: M21.6x1 Other acquired deformities of right foot and/or M21.6x2 Other acquired deformities of left foot.
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Coding is sometimes not clear cut. You must have a resource available. I use one that enables one to drill down to make sure the choice provided is accurate. Relying on the “Index” and/or the “Mapping” of codes cannot be completely trusted. It is in the tabular section that we ultimately make our coding decision. This is where I find the most specific code for my diagnoses and so should you!
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This ezine was supported by an educational Grant from:
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