Orthopedic Coding Alert

Question: In the past, we coded hip impingement as 726.5. Now one of our physicians questions the code because he says it is not bursitis. He suggested we should look for a femoroacetabular impingement diagnosis. What's the best choice?

Delaware Subscriber

Answer: Your physician is correct in saying you shouldn't report 726.5 (Enthesopathy of hip region) in this situation, because it's a bursitis diagnosis.

New tactic: ICD-9 does not include a specific diagnosis code for femoroacetabular impingement syndrome, but some payers such as Aetna recommend you report 719.45 (Pain in joint; pelvic region and thigh) or 719.85 (Other specified disorders of joint; pelvic region and thigh). Check your payer's guidelines before finalizing your claim to verify the diagnosis they accept and whether it correlates to your case.

-- Reader Questions and You Be the Coder were reviewed by Heidi Stout, CPC, CCS-P, director of orthopedic coding services at The Coding Network LLC; and Bill Mallon, MD, orthopedic surgeon and medical director at Triangle Orthopaedic Associates in Durham, N.C.