Know these updates to juvenile osteochrondosis and arthritis coding. 2021 ICD-10-CM changes relevant to orthopedic coding will go into effect Oct. 1, 2020. Use the next few weeks to become comfortable with the changes before you need to implement them in your coding. What’s included? Look for three major revisions to juvenile osteochrondosis (JO) coding, an additional character for arthritis codes, and a fifth character — 9 — to some code sets. Know These JO Changes During her presentation “Juvenile Osteochondroses,” Nathalie Gaulier, MD, sports medicine physician at Cook Children’s Medical Center, defined the condition: According to Codify, JO “may cause a dull, nonspecific aching sensation in the joints of the affected area, especially upon application of pressure. Providers diagnose the condition based on personal history of symptoms, physical examination, and confirmation with X–ray. Treatment options are largely conservative, including rest for several days, followed if needed by application of a cast to restrict joint movement; rarely, surgical intervention may be required to remove abnormal bone fragments.” Note How Revisions Add Detail to JO Dx The first JO-related revision is M92.50 (Juvenile osteochondrosis of tibia and fibula, unspecified leg), whose descriptor will change to M92.50 (Unspecified juvenile osteochondrosis of tibia and fibula) in October. The M92.50- code set will also welcome these additions to its rolls: The second revision is M92.51 (Juvenile osteochondrosis of tibia and fibula, right leg), whose descriptor will change to M92.51 (Juvenile osteochondrosis of proximal tibia) in October. The M92.51- codes will also get these additions in October: The third revision is M92.52 (Juvenile osteochondrosis of tibia and fibula, left leg), whose descriptor will change to Use the ‘A’ Option for These Arthritis Codes As for new diagnosis options for conditions relative specifically to orthopedics, ICD-10 is adding several codes with an “A” character to some of its sets in the Diseases of the musculoskeletal system and connective tissue (M00-M99) Chapter. For instance, M05.7 (Rheumatoid arthritis with rheumatoid factor without organ or systems involvement) will add M05.7A (Rheumatoid arthritis with rheumatoid factor of other specified site without organ or systems involvement) to give you another fifth-character option for this condition. Also, M05.8 (Other rheumatoid arthritis with rheumatoid factor) will add M05.8A (Other rheumatoid arthritis with rheumatoid factor of other specified site). Other new codes from this set for 2021 include: Don’t Miss ‘9’ in These Code Sets Just as with the addition of new fifth characters with the aforementioned codes, ICD-10 will add the fifth-character option of “9” or “A” to several other code sets. For example, ICD-10 will add M19.09 (Primary osteoarthritis, other specified site) to the M19.0 (Primary osteoarthritis of other joints) code set in October. Also, M19.1 (Post-traumatic osteoarthritis of other joints) will add M19.19 (Post-traumatic osteoarthritis, other specified site). Other new codes from this set for 2021 include: