Wiki Arthritis Dx HELP

[Sara82]

Pt is a coming from workers comp. She got approved with the dx of 716.56(Polyarthritis;5 or more joints simultaneously). Doctors dictation only states tricompartmental osteoarthritis and more moderate changes of the femoral tibial joint space. For tricompartmental osteoartritis I used 715.36, but WC is denying the claim.

Did I use the right dx? I believe I did, but Im starting to doubt myself and I would like some others input about it before I go talk to the doctor about this.

TIA

 

[jdemar]

715.3X is for degenerative, I would have used 716.X for traumatic.because it is Workers Comp., verify with the Dr. that it is from the pt's. injury.

 

[madgejones10]

If you have a WC for USPO or DOD, you MUST use the "accepted" diagnosis whether you
agree with it or not if you wish to get paid. Government WC is a totally different breed of cat and the "accepted" diagnosis, as long as it is the same body part, and somwhat close, must be used. Strange, but TRUE !!

 

[jdemar]

I do know that, but shouldn't you complete and submit a C-9 form to Ohio W Comp. and have it corrected to reflect the correct diagnosis?