Orthopedic Coding Alert

Unspecified condition now has codes for specific body areas.

ICD-10 just settled on its list of new, revised, and deleted codes for 2025, and it has several additions that will be relevant to your practice.

The facts: ICD-10 2025 contains nearly 350 additions, deletions, and revisions to the 2024 roll of ICD-10 codes. Several of these changes are going to be relevant to orthopedic coders.

Do this: Get used to these codes before you have to start using them by checking them out early. Remember, you are supposed to use the 2025 ICD-10 code list on October 1, 2024.

Several Codes Converted to Parents

There are several ICD-10 codes that were converted to “parent” codes, and will spawn new codes that are under the parent code’s heading.

The first code that will covert to parent in October is M51.36 (Other intervertebral disc degeneration, lumbar region). When the code becomes M51.36-, these will be your 6th character options:

• M51.360 (Other intervertebral disc degeneration, lumbar region with discogenic back pain only)
• M51.361 (Other intervertebral disc degeneration, lumbar region with lower extremity pain only)
• M51.362 (Other intervertebral disc degeneration, lumbar region with discogenic back pain and lower extremity pain)
• M51.369 (Other intervertebral disc degeneration, lumbar region without mention of lumbar back pain or lower extremity pain)

Impact: This move will make M51.36 a code set that includes descriptions indicating the absence/presence of lower extremity pain, discogenic back pain, and lumbar back pain.

Finally, ICD-10 also converted M51.37 (Other intervertebral disc degeneration, lumbosacral region) to parent for 2025. When this code starts requiring a 6th character, these will be your options:

• M51.370 (Other intervertebral disc degeneration, lumbosacral region with discogenic back pain only)
• M51.371 (Other intervertebral disc degeneration, lumbosacral region with lower extremity pain only)
• M51.372 (Other intervertebral disc degeneration, lumbosacral region with discogenic back pain and lower extremity pain)
• M51.379 (Other intervertebral disc degeneration, lumbosacral region without mention of lumbar back pain or lower extremity pain)

Impact: Much like M51.36, the expansion of M51.37 will result in a code set that includes descriptions indicating the absence/presence of lower extremity pain, discogenic back pain, and lumbar back pain.

M65.9- Gets Parental Conversion, Lots of ‘Kids’

Perhaps the most detailed conversion of a code to parent is M65.9 (Synovitis and tenosynovitis, unspecified), which will be converted to parent in October, leading to a slew of new codes.

Here’s a look at some of the new codes that will grace ICD-10 in October:

• M65.90- (Unspecified synovitis and tenosynovitis, unspecified site)
• M65.91- (Unspecified synovitis and tenosynovitis, shoulder)
• M65.92- (Unspecified synovitis and tenosynovitis, upper arm)
• M65.93- (Unspecified synovitis and tenosynovitis, forearm)
• M65.94- (Unspecified synovitis and tenosynovitis, hand)
• M65.95- (Unspecified synovitis and tenosynovitis, thigh)
• M65.96- (Unspecified synovitis and tenosynovitis, lower leg)
• M65.97- (Unspecified synovitis and tenosynovitis, ankle and foot)
• M65.98 (Unspecified synovitis and tenosynovitis, other site)
• M65.99 (Unspecified synovitis and tenosynovitis, multiple sites).

Note: The majority of these codes will require a 6th character to indicate laterality (left, right, unknown). This new code set will make reporting synovitis/tenosynovitis more specific, which should help to target patient care. Make sure to code as specifically as possible on your unspecified synovitis/ tenosynovitis claims with these new codes.

Chris Boucher, MS, CPC, Senior Development Editor, AAPC