Four Common Bone Disorders and Their ICD-10 Codes

by | Published on Jul 23, 2020 | Resources | 0 comments

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Bones help you move and support your body. Bones continuously change – new bone is made and old bone is broken down. When people are young, the body makes new bones faster than it breaks down old bone and the body mass increases. In order to have strong bones (when you are young) and to prevent bone loss (when you are older), it is important to get adequate amount of calcium, Vitamin D, and exercise. Bone diseases refer to a condition that damages the skeleton and makes it weak and prone to fractures. Diseases and injuries of bones are major causes of abnormalities of the human skeletal system. Generally, most people reach their peak bone mass around the age of 30 years. After that, bone remodeling continues, however you lose slightly more bone mass than you gain. Treatment for bone conditions aims at maintaining healthy bone mineral density and bone mass, preventing fractures and reducing pain. Medical specialists treating bone disorders can rely on medical billing companies to meet their claim submission tasks and thus receive reimbursement on time.

Here discussed are the top four bone disorders and their related ICD-10 codes –

Osteoporosis – Osteoporosis is a condition that causes the bones to become weak and brittle, so that even a mild fall or stress can cause a fracture. Reports from the International Osteoporosis Foundation (2019 statistics) say that on a global level, osteoporosis causes more than 8.9 million fractures annually, resulting in an osteoporotic fracture every 3 seconds. These fractures mostly occur in the hip, wrist or spine. It is estimated that osteoporosis is much more common in females than in males as the bone minerals are lost very fast 3-8 years after menopause. Typically, there are no specific signs and symptoms of osteoporosis in the early stages of bone loss. However, once the bones get weakened by the condition, people may experience symptoms like severe back pain, loss of height over time, a stooped posture, and a bone that breaks much more easily than expected. Medications, a healthy diet, and weight-bearing exercise can help prevent bone loss or strengthen weak bones in the long run. Common ICD-10 codes for this condition include –

  • M80 Osteoporosis with current pathological fracture
  • M80.0 Age-related osteoporosis with current pathological fracture
    • M80.01 Age-related osteoporosis with current pathological fracture, shoulder
    • M80.02 Age-related osteoporosis with current pathological fracture, humerus
    • M80.03 Age-related osteoporosis with current pathological fracture, forearm
    • M80.04 Age-related osteoporosis with current pathological fracture, hand
    • M80.05 Age-related osteoporosis with current pathological fracture, femur
    • M80.06 Age-related osteoporosis with current pathological fracture, lower leg
    • M80.07 Age-related osteoporosis with current pathological fracture, ankle and foot
    • M80.08 Age-related osteoporosis with current pathological fracture, vertebra(e)
  • M80.8 Other osteoporosis with current pathological fracture
  • M81 Osteoporosis without current pathological fracture
    • M81.0 Age-related osteoporosis without current pathological fracture
    • M81.6 Localized osteoporosis [Lequesne]
    • M81.8 Other osteoporosis without current pathological fracture

Osteomalacia – Osteomalacia refers to a marked softening and weakening of the bones. In children and young adults, softened bones can cause bowing during growth, especially in the weight-bearing bones of the legs. Osteomalacia in older adults can lead to fractures. Vitamin D deficiency is one of the most common causes of osteomalacia. Vitamin D can help maintain calcium and phosphate levels to help bones form properly. Bone fractures and muscle weakness are the common symptoms associated with the condition. A dull, aching bone pain that spreads from the hips towards the lower back area, pelvis, legs and ribs is another prominent symptom. If left untreated, osteomalacia can lead to broken bones and severe bone deformity. Consuming oral supplements of vitamin D, calcium, or phosphate may be the first line treatment for this condition. Related ICD-10 codes include –

  • M83 Adult osteomalacia
  • M83.0 Puerperal osteomalacia
  • M83.1 Senile osteomalacia
  • M83.2 Adult osteomalacia due to malabsorption
  • M83.3 Adult osteomalacia due to malnutrition
  • M83.4 Aluminum bone disease
  • M83.5 Other drug-induced osteomalacia in adults
  • M83.8 Other adult osteomalacia
  • M83.9 Adult osteomalacia, unspecified

Paget’s disease of bone – Regarded as a chronic disease of the bone, Paget’s disease of bone interferes with the body’s normal recycling process, wherein the new bone tissue gradually replaces old bone tissue. Also called Osteitis deformans, the disease can cause affected bones to become fragile and misshapen. This bone disease most commonly occurs in the spine, pelvis, legs and skull. In healthy bone structure, a remodeling process removes old pieces of bone and replaces them with new, fresh bone. The paget’s bone condition causes this process to shift out of balance, making the new bone become weak and brittle. In most cases, the condition commonly affects older people as about 2-3 percent of the population above 5 years. The risk of this condition increases with age. Complications associated with this disorder include – broken bones, hearing loss and pinched nerves in your spine. Patients suffering from this bone disorder do not experience any specific symptoms during the early stages. However, as the condition progresses, symptoms like bone pain could occur. Treatment for this bone condition involves taking medications (oral bisphosphonates) that help slow or stop the progress of the disease. On the other hand, for patients who have complications, surgery may be recommended as an option to realign deformed bones or to help fractures heal properly. ICD-10 codes for diagnosing Paget’s disease include –

  • M88 Osteitis deformans [Paget’s disease of bone]
    • M88.0 Osteitis deformans of skull
    • M88.1 Osteitis deformans of vertebrae
    • M88.8 Osteitis deformans of other bones
      • M88.81 Osteitis deformans of shoulder
      • M88.82 Osteitis deformans of upper arm
      • M88.83 Osteitis deformans of forearm
      • M88.84 Osteitis deformans of hand
      • M88.85 Osteitis deformans of thigh
      • M88.86 Osteitis deformans of lower leg
      • M88.87 Osteitis deformans of ankle and foot
      • M88.88 Osteitis deformans of other bones
      • M88.89 Osteitis deformans of multiple sites
    • M88.9 Osteitis deformans of unspecified bone

Osteogenesis imperfecta (OI) – Also called Brittle bone disease, Osteogenesis imperfecta (OI) is a condition that results in fragile or brittle bones that break or fracture easily. The condition arises from a genetic defect that causes abnormal or reduced production of the protein collagen – a major component of connective tissue. Reports suggest that approximately one person in 20,000 will develop brittle bone disease. It occurs equally among males and females and among ethnic groups. OI can at times be life-threatening, if it occurs in babies either before or shortly after birth. The condition can range from mild to severe and result in severe complications like hearing loss, permanent deformities, spinal cord problems and heart failure. Symptoms of this condition include – multiple broken bones, weak teeth, scoliosis, loose joints, kyphosis, bowed legs and arms and blue sclera (bluish color in the white of the eye). There is no specific cure for brittle bone disease. However, supportive therapies like physical and occupational therapy, low-impact exercises and bisphosphonate medications can help reduce the risk of broken bones and increase the patient’s quality of life. ICD-10 code for diagnosing OI-

  • Q78.0 Osteogenesis imperfecta

There are specific ICD-10 codes to report bone conditions. Medical billing and coding for bone disorders can be challenging. Physicians need to have proper knowledge about the specific ICD-10 codes to report common bone disorders. Outsourcing medical billing requirements to experienced medical billing service providers is an effective way to ensure the correct medical codes on your claims and thereby optimal reimbursement.

Natalie Tornese

Holding a CPC certification from the American Academy of Professional Coders (AAPC), Natalie is a seasoned professional actively managing medical billing, medical coding, verification, and authorization services at OSI.

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