Orthopedic Coding Alert

Question: What is the correct code for Charcot's arthropathy when there is no documentation of syphilis? Is it correct to report code 094.0 (Tabes dorsalis)? Missouri SubscriberAnswer: Code 094.0 is not the appropriate code for Charcot's arthropathy when there isn't any documentation for syphilis. You may report codes 349.9 (Unspecified disorders of nervous system) and 713.5 (Arthropathy associated with neurological disorders) when your provider does not document for syphilis. The code for Charcot arthropathy (713.5) is a manifestation code; therefore, it is always reported as a secondary code with the underlying disease code reporting first. It is better to verify whether or not the patient has diabetic Charcot arthropathy, the most likely scenario, which would be reported with codes 250.6x (Diabetes with neurological manifestations) and 713.5. If the underlying disease is not specified, ICD 9 guidelines dictate that code 094.0 (Tabes dorsalis) be reported as the primary diagnosis code.