Every year, orthopedics medical billing and coding companies receive a large volume of requests from orthopedic practices to accurately code, bill, and collect payment for services provided to diagnose and treat osteoarthritis (OA). The most common form of arthritis, OA involves joint degeneration and affects more than 20 million individuals in the US alone. The disease is the leading cause of chronic disability and can affect three or more joints or a localized one such as the knee.
As baby boomers age, OA is one of the most pressing medical research challenges of the twenty-first century. The discovery a new blood test that can diagnose osteoarthritis early by experts at Warwick University in the UK is an exciting breakthrough. According to the researchers, the blood test can diagnose patients with early-stage arthritis several years before the physical and irreparable symptoms begin. They say the test can also distinguish OA from rheumatoid arthritis (RA) and other inflammatory joint diseases. Early detection can prevent OA from becoming painful and debilitating and provide the opportunity for effective treatment and implementing corrective lifestyle changes.
The new blood test looks for chemical signs in fragments of damaged joint proteins or amino acids. The study involved patients with early-stage and advanced OA, RA or other inflammatory joint disease and a control group of people with good skeletal health. The researchers analyzed plasma and synovial fluid samples from both groups using mass spectrometry. Samples of the patients with early and advanced OA and RA were found to have much higher levels of damaged proteins in characteristic patterns compared to those of the control group. By measuring the small fragments from damaged proteins that leak from the joint into blood, this unique blood test enables early stage detection and categorization of arthritis as OA, RA or other inflammatory joint conditions. According to the researchers, the test could be commercially available within two years.
Currently, orthopedists and rheumatologists rely on medical history and physical examination, and radiographic and imaging tests to diagnose osteoarthritis. Analysis of blood or joint fluid can help confirm the diagnosis. Submission of proper documentation and the right codes is crucial for optimal reimbursement. Examples of the ICD-10-CM Diagnosis Codes for osteoarthritis:
- M15.0 Primary generalized (osteo)arthritis
- M15.1 Heberden’s nodes (with arthropathy)
- M15.3 Secondary multiple arthritis
- M15.4 Erosive (osteo)arthritis
- M16.0 Bilateral primary osteoarthritis of hip
- M16.1 Unilateral primary osteoarthritis of hip
- M16.2 Bilateral osteoarthritis resulting from hip dysplasia
- M16.4 Bilateral post-traumatic osteoarthritis of hip
- M16.50 Unilateral post-traumatic osteoarthritis, unspecified hip
- M17.1 Unilateral primary osteoarthritis of knee
- M18.0 Bilateral primary osteoarthritis of first carpometacarpal joints
- M19.011 Primary osteoarthritis, right shoulder
- M19.012 Primary osteoarthritis, left shoulder
Outsourcing medical billing and coding to a reliable company will ensure the services of a dedicated group of specialists to ensure appropriate reimbursement for the diagnosis and treatment of this painful and debilitating joint disorder.
The new blood test was found to have a sensitivity of 92 percent and a specificity of 90 percent in detecting early-stage osteoarthritis. This compares favorably with current techniques such as magnetic resonance imaging (MRI) which has sensitivities around 70 percent and specificities around 90 percent. Moreover, the researchers point out that imaging tests such as MRI are expensive and time-consuming, and cannot be used with patients who have pacemakers.