# Chondral defect



## sxcoder1

Wondering what people are using for "chondral defect" , i.e. femoral, trochlear, humeral head, etc.


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## Gran1234

Cartilage derangement code.


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## graceroni13

For ICD-9, we were using 733.92. So I would do the chondromalacia, but not patellae...


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## sxcoder1

Thank you.  I've been using different ones, other internal derangement, knee M23.8X.... , chondromalacia M94.26...., and other specified disorders of cartilage M94.8X6, so was wondering what others were using.


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## amymeyers01

I have used the other specified disorder of cartilage code unless they specify that it is intra-articular cartilage.  I use the derangement codes if the defect is documented as intra-articular.  I wouldn't use chondromalacia if they don't specify that the defect is softening or degeneration of cartilage.  I have wondered if it should actually go under acquired deformity since that is how osteochondral defect is listed in the index.  It is a bit of gray area on some of these!


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## sxcoder1

Now I've been looking at M95.8 also, other specified acquired deformities of musculoskeletal system which does seem ok as well.


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## AlanPechacek

*Articular Cartilage Defect*

For an isolated "articular cartilage defect" the most specific code would be M94.8X _:  Other Specified Disorders of Cartilage (of joint).  Although this code set includes the knee (lower leg: 6) and does not appear to exclude the Patella, I think that for the Patella, M22.8 _ (Other Disorders of the Patella) would be more correct.  M24.8 _: Other Specified Derangement of Joint NEC seems to me to be far less specific.  This is the simplest answer to the question, but this can be only a part of the joint problem.  Other concerns are the presence or absence of a Cartilaginous Loose Body(s) originating from the "defect," and/or is there other articular cartilage disease of the joint, such as Chondromalacia?

Chondromalacia is "softening" of the articular cartilage, with varying degrees of depth and severity of involvement.  It can progress to the point of producing an articular cartilage defect all the way to the bone underneath. For all joints and areas other than the Patella, M94.2 _ _ would apply to the associated Chondromalacia, if present.  For Patellar Chondromalacia, if associated with an articular cartilage defect, then M22.4 _ would apply.  However, the presence of Chondromalacia in any joint or area does not necessarily mean there is an articular cartilage defect, but the two can occur simultaneously/concurrently.

An articular cartilage defect can also be associated with &/or the source of a Cartilaginous Loose Body in the affected joint.  For the knee joint, the code for an associated Loose Body would be M23.4 _; but for other joints, it would be M24.1 _ _.

I would be careful about "Cartilage Derangement" as regards this problem/issue.  As it applies to the knee joint, "Cartilage Derangement" applies to meniscal tears, not articular cartilage disorders.   

I hope this is more helpful than confusing.

Respectfully submitted, Alan Pechacek, M.D.


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## sxcoder1

That was helpful, thank you.


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