# icd9 decreased rom elbow



## mamacase1 (Oct 10, 2010)

Can someone tell me what ICD9 you would use for decreased range of motion for an elbow?


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## sleepycats (Oct 10, 2010)

How about 719.62 (Other symptoms referable to joint, upper arm)?


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## mamacase1 (Oct 11, 2010)

Thank you for yur help that will work.


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## sleepycats (Oct 11, 2010)

Glad to help!!


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## rajkumark (Oct 18, 2010)

Hi I would suggest 719.52 - Stiffness of the joint this may lead to decreased range of movement instead of 719.62. Please add your inputs.


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## preserene (Oct 18, 2010)

Otherwise known as Elbow Mobility Deficits- ulnohumeral capsulitis Diagnosis code 812.40.

The etiological factors could be trauma, stiffness following immobilization and healing processes; Pain at the end range of supination and/or pronation; Related to the reported activity limitation or participation restrictions

 Would it go with your case? Hope so!


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## JulesofColorado (Oct 19, 2010)

812.40 is fracture of the humerus, so that won't work.


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## sleepycats (Oct 19, 2010)

I think using anything besides 719.62 is assuming the cause of the decreased ROM.  It could be dislocated, nursemaid elbow, OA, etc.


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## preserene (Oct 19, 2010)

Well, instead of saying"That wont work , give your self to a little analysis.
See ,I said (in dealing with the particular sequlae of a causation) the underlying pathophysiology (3salient features of ROM) here, is a trauma/injury to the lower end of the bone and as the sequlae of immobilization/stiffness/or during healing process this mobility dificit occurs.
Just as we go with many other causative/underlying pathology(say like Diabetes,we always report it along with it sequlae).
So here the primary Path is fracture of the lower end which causes the ulnohumeral deficit at elbow. 
Based on the salient features of the deficit process the major cause being Fracture of the lower end of humerus. 
719.12 though not to be denied , to make it more specifis and supportive the underlying pathology could be added.
 Tennis elbow, nurse elbow Arthritis,cubital tunnel Syndrome and so on are not categoried in ROM though we feel they could too.
Are you all really satisfied with 719.62  alone to depicts ROM or do you feel particular  catogorical  causative  factor could be included in event of 719.62 not being specific?


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## gost (Oct 20, 2010)

If all you have to code by is "decreased range of motion," 719.62 is the best (maybe only) choice.  You cannot assume a cause.  The elbow joint probably is stiff but we don't know that based on the documentation.  

This comes from the justcoding.com web site:

 "The OIG defines assumption coding as "assuming (and coding) from the clinical evidence on the patient's record that the patient has certain diagnoses in the absence of the physician's explicit documentation of the diagnosis."  Assumption coding is a forbidden practice among coders. 
In other words, assumption coding occurs when the coder "assumes" certain facts about a patient's condition although the physician has not specifically documented the level of detail that the coder is coding."


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## preserene (Oct 20, 2010)

Your "welwish" is acceptable to some extent. Genarally you cannot take all things that are not put up in the op notes, as assumption; medical necessity , analysing the real merits of the condition with the critical thinking and  are also often needed using the more highest specificity of reporting,(when there is adilemma in the assignmentor no straight forward code available; this cannot be labelled as "Assumption Code". 
Well, when it occurs in your mind that it means sense, logical, and above all medically necessary, you CAN ALWAYS clarify politely with your physicians  who would not have placed all the needed facts  in his fast track.,
my posts are often of suggestion values, just to ponder whether acceptible. That is why we come to forum to discuss. 
well I am not for arguement any more.
Any way thank you for a valuable info


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## dr.dorwin (Feb 9, 2015)

*Decreased ROM*

I Agree with 719.62. Decreased ROM may occur due to many conditions. So we can't assume Stiffness or any other condition. 

Dorwin D, BPT, CPC, CPC-H, CANPC, CPMA
Certified ICD-10cm Coder,
Anesthesia coding Specialist,


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## balamurugan.ph (Feb 17, 2015)

*Decreased ROM Elbow*

719.63 it would be the correct diagnosis for Decreased ROM Elbow


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## JMA (Feb 20, 2015)

My two cents... Decreased ROM is also known as Limited Range of Joint Motion.  I don't have my book or my encoder with me, but I know that limited ROM codes to stiffness of a joint.  

It's true that you don't know the underlying disease process causing the decreased ROM, such as arthritis... but I think by the definitions of decreased ROM/limited ROM (aka, stiffness) and normal/active ROM I don't think an assumption is being made when coding 719.52... which is probably why you're directed to stiffness from limited ROM.  You may also see a case example here for coding limited ROM.  https://books.google.com/books?id=_eIWAAAAQBAJ&printsec=frontcover#v=onepage&q&f=false  Search for the term limited range of motion and it will bring you to the correct page.


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