Eli's Rehab Report
You May Want to Report 726.39 for Bone Spur
Question: What is the correct diagnosis code for an olecranon bone spur? ICD-9 points to 726.91, but several insurers will not accept unspecified codes. Should I use 213.4 instead?
Ohio Subscriber
Answer: Many coders share your frustration with this scenario because the ICD-9 index refers you to the enthesopathy codes for spurs of certain anatomic sites (such as calcaneus, iliac crest), but not others, such as the elbow.
726.91 (Exostosis of unspecified site) may not be the best option for bone spurs because the descriptor refers to an "unspecified site." Because you know that the patient has an olecranon spur, your patient's site is no longer considered "unspecified."
Instead of 213.4 (Benign neoplasm; scapula and long bones of upper limb), you may want to report 726.39 (Enthesopathy of elbow region; other), because this code specifies the region and classifies the condition as an "other."
Eli's Rehab Report
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