Orthopedic Coding Alert

Question: Does the term juvenile in juvenile osteochondrosis (732.x) refer to the physical age of the patient or the stage of the disease? When the diagnosis is osteochondral defect, which code is used?

New Jersey Subscriber

 
Answer: As most osteochondroses are diseases affecting the growth centers in children, they are referred to as juvenile. Therefore, the term refers to diseases affecting children, and the codes are not appropriate for adults. The adult form of this process is coded with 732.7 (osteochondritis dissecans) or 732.8 (other specified forms of osteochondropathy).
 
When your physician uses the term osteochondral defect, he is referring to a defect in the articular cartilage, the tough, elastic tissue that covers the ends of bones in joints. Unfortunately, there is no ICD-9 code that specifically describes this condition. ICD-9 directs you to report an articular cartilage disorder of the knee with 717.9 (unspecified derangement of  knee).