Orthopedic Coding Alert

Question: What is the appropriate ICD-9 code for an acute triangular fibrocartilage tear and ulnar abutment? Ohio Subscriber Answer: Most likely, the ulnar abutment caused the triangular fibrocartilage complex (TFCC) tear. If so, you should report 718.03 (Articular cartilage disorder; forearm) rather than an acute code, such as 842.01 (Sprains and strains of wrist and hand; wrist; carpal [joint]) for the diagnosis. For the ulnar abutment, report 718.83 (Other joint derangement, not elsewhere classified; forearm). The TFCC is on the ulnar side of the wrist and is made of cartilage and ligaments. Sports injuries may also cause TFCC tears, typically by the patient landing on his outstretched arm or repetitive heavy lifting with the ulnar side of the wrist. Ulnar impaction syndrome is a degenerative wrist condition often related to excessive load bearing. You may often see it in workers- compensation patients.