arthropathy

jill.sanborn@midmichigan.orgjill.sanborn@midmichigan.org
in Home Care Coding General
Does anyone know how to code L shoulder rotator cuff arthropathy?

Comments

  • vmirabella@utopiahomecare.comvmirabella@utopiahomecare.com
    edited May 2017
    Would you know if it is traumatic?
  • jill.sanborn@midmichigan.orgjill.sanborn@midmichigan.org
    Unfortunately, it does not say. She had a shoulder arthroplasty for it, so I am using an aftercare code because it didn't specify traumatic. I found m12.812, but I don't feel that is appropriate either.
  • Nancy.Wolverton@kindred.comNancy.Wolverton@kindred.com
    edited May 2017
    Jill,
    When stated as such, no it is not traumatic.
    Definition:
    A condition of the shoulder that consists of arthritis associated with an irreparable rotator cuff tear.
    This condition usually occurs in older individuals and results in a painful shoulder with loss of motion
    and strength.

    These folks usually are offered a reverse total shoulder as a last resort for treatment for the chronic pain and limited ROM. You code the rotator cuff tear M-code

    Nancy Wolverton RN, CCM, HCS-D-10
    Utilization Review Specialist
    Kindred at Home
    Little Rock, Arkansas
    501-508-8526 (o)
    501-690-2027 (c)
    Nancy.Wolverton@kindred.com
  • Nancy.Wolverton@kindred.comNancy.Wolverton@kindred.com
    edited May 2017
    However that condition can be the result of degenerative conditions of the bone and rotator cuff as well as after fractures, failed rotator cuff surgery or failed partial/ total shoulder replacements. A sequalea if you will.. or not. If no etiol stated, then code as no injury. One can always ask the provider for clarification..

    Nancy Wolverton RN, CCM, HCS-D-10
    Utilization Review Specialist
    Kindred at Home
    Little Rock, Arkansas
    501-508-8526 (o)
    501-690-2027 (c)
    Nancy.Wolverton@kindred.com
Sign In or Register to comment.