Orthopedic Coding Alert

Can you find the diagnosis codes in this patient's history?

Sometimes it may seem as if there's an ICD-9 code for everything, but it can be difficult to find the one you-re looking for when you need it. Grab your ICD-9 manual and test your coding skills by filling in the codes for this life story. The answers appear below the quiz.

My life began on a sunny November morning when I was born to my wonderful parents. Shortly after my birth, I was diagnosed with shoulder subluxation (Dx 1: _____) and neonatal brachial plexus palsy (Dx 2: __).

I was an avid tree climber as a child, and I fell out of a tree once (E code Dx 3:____), which caused a Colles fracture (Dx 4: _____) and a closed tibia shaft fracture (Dx 5: ___). 

I got my first job at the age of 17, when I worked as a house painter. I fell off a ladder one day (E code
Dx 6: ____) and broke my collar bone (Dx 7:_____). After I healed from that, I stayed away from heights and went to college on a tennis scholarship. After three years of daily tennis playing, I experienced tennis elbow (Dx 8: _____) and rotator cuff tendinitis (Dx 9: _____).

Ever since I graduated from college, I haven't had too much time for sports, so now I walk for exercise and garden on the weekends for leisure. Kneeling in the garden has exacerbated osteoarthritis in my knees (Dx 10: ___). The doctor also said I should start taking calcium supplements because he thinks I have the early signs of osteoporosis (Dx 11: ____). 

Review the answers to our ICD-9 coding quiz to see how well you scored in matching the patient's history to the most appropriate ICD-9 codes.

Answers

Diagnosis code 1: 755.59 (Other anomalies of upper limb, including shoulder girdle; other) or 767.3 (Other injuries to skeleton due to birth trauma), depending on the documentation.

Diagnosis code 2: 767.6 (Injury to brachial plexus due to birth trauma)

Diagnosis code 3: E884.9 (Fall from tree)

Diagnosis code 4: 813.41 (Colles- fracture, closed)

Diagnosis code 5: 823.20 (Fracture of tibia and fibula; shaft, closed; tibia alone)

Diagnosis code 6: E881.0 (Accidental falls; fall on or from ladders or scaffolding; fall from ladder).

Diagnosis code 7: 810.02 (Fracture of clavicle;closed; shaft of clavicle)

Diagnosis code 8: 726.32 (Lateral epicondylitis)

Diagnosis code 9: 726.11 (Calcifying tendinitis of shoulder)

Diagnosis code 10: 715.36 (Osteoarthrosis, localized, not specified whether primary or secondary; lower leg)

Diagnosis code 11: 733.00 (Osteoporosis, unspecified)

Note: Remember that E codes, such as E881.0, are supplemental codes only, and you should not use them as primary diagnoses.