Wiki Could someone help with a coding question about spinal stenosis?

[Aprilsoul]

Hello this is my very first post. I am a little confused on the excludes note in ICD-9 code set 724.0& I was wondering if anyone could provide some feedback please.
I had a chart with several dx for the patient and one was spinal stenosis and the other was osteoporosis. I coded 724.00 and 733.00 but then I was advised that was incorrect(via a supervisor audit) because spinal stenosis excludes osteoporosis, but based on the excludes note I thought it would only exclude it if it was documented that the patient had a collapsed vertabrae or spinal stenosis due to an intervertebral disc disorder. So I do not understand. A pt can have osteoporosis throughout all the bones of their body and that does not neccesarily exclude spinal stenosis to me. And if my auditor is correct then why is there no excludes for 733.0X regarding spinal stenosis. I really wanted to dispute this, but was not sure.
Thanks for any help!

 

[ajs]

Hello this is my very first post. I am a little confused on the excludes note in ICD-9 code set 724.0& I was wondering if anyone could provide some feedback please.
I had a chart with several dx for the patient and one was spinal stenosis and the other was osteoporosis. I coded 724.00 and 733.00 but then I was advised that was incorrect(via a supervisor audit) because spinal stenosis excludes osteoporosis, but based on the excludes note I thought it would only exclude it if it was documented that the patient had a collapsed vertabrae or spinal stenosis due to an intervertebral disc disorder. So I do not understand. A pt can have osteoporosis throughout all the bones of their body and that does not neccesarily exclude spinal stenosis to me. And if my auditor is correct then why is there no excludes for 733.0X regarding spinal stenosis. I really wanted to dispute this, but was not sure.
Thanks for any help!

I have to agree with you. The excludes note reads:
collapsed vertebra (code to cause, e.g., osteoporosis, 733.00-733.09)
conditions due to:
intervertebral disc disorders (722.0-722.9)
spondylosis (721.0-721.9)

To me that reads "it does not include collapsed vertebra due to osteoporosis" You are saying that the patient had unspecified spinal stenosis and osteoporosis...no collapsed vertebra or other disc specific disc disorders. Would seem like the codes are ok together, but perhaps someone else will have a different opinion.

 

[Aprilsoul]

Thank you very much for your feedback. I have had a chance to speak with a few other coders in our office and they agree with me as well. Have a good afternoon.