The M91-M94 range in ICD-10 focuses on Chondropathies, a group of conditions affecting the cartilage. These codes cover various types of chondropathies including osteochondrosis, chondromalacia, and other disorders of cartilage. The codes are designed to provide detailed information about the type of chondropathy, its location, and any associated complications.

Key Usage Points:

•Always code to the highest level of specificity.
•Use additional codes to identify any associated conditions.
•Consider the patient's age and medical history when coding.
•Always verify the code in the Tabular List.
•Use a combination code when a single condition involves multiple sites.

Coding Guidelines

When to Use:

✓When a patient is diagnosed with a specific type of chondropathy.
✓When a patient has a condition that affects the cartilage in multiple sites.
✓When a patient has a chondropathy as a result of a previous injury or surgery.
✓When a patient's chondropathy is causing additional complications.

When NOT to Use:

✗When the patient's condition does not affect the cartilage.
✗When the patient's condition is still under investigation.
✗When the patient's condition is better represented by another code.
✗When the patient's condition is a result of an external cause.

Code Exclusions

Always verify exclusions in the Tabular List.

Documentation Requirements

Proper documentation for chondropathies should include a clear diagnosis, the specific type of chondropathy, the location of the condition, and any associated complications. The patient's medical history and any relevant clinical findings should also be documented.

Clinical Information:

•Specific type of chondropathy
•Location of the condition
•Associated complications
•Patient's medical history
•Relevant clinical findings

Supporting Evidence:

•Medical imaging reports
•Laboratory test results
•Operative reports
•Physician's clinical notes

Good Documentation Example:

Patient diagnosed with osteochondrosis of the knee, confirmed by MRI. Patient has a history of sports injuries.

Poor Documentation Example:

Patient has knee pain.

Common Documentation Errors:

⚠Not coding to the highest level of specificity
⚠Not documenting the specific type of chondropathy
⚠Not documenting the location of the condition
⚠Not documenting any associated complications

Range Statistics

Total Codes

149

Billable

Complexity:

Medium

Primary Use:Clinical Documentation

Chapter:13

Coding Complexity

Medium

Complexity Rating

Coding for chondropathies can be complex due to the need to identify the specific type of chondropathy, its location, and any associated complications. The extensive range of codes can also add to the complexity.

Key Factors:

▸Determining the specific type of chondropathy
▸Identifying the location of the condition
▸Identifying any associated complications
▸Understanding the patient's medical history
▸Navigating the extensive range of codes

Specialty Focus

These codes are primarily used by orthopedic specialists, rheumatologists, and sports medicine physicians. They can also be used by primary care physicians when managing patients with chondropathies.

Primary Specialties:

Orthopedics

50%

Rheumatology

30%

Sports Medicine

20%

Clinical Scenarios:

• A patient with osteochondrosis of the knee due to a sports injury.
• A patient with chondromalacia patellae due to overuse.
• A patient with a disorder of the cartilage due to a previous surgery.
• A patient with a chondropathy affecting multiple sites.

Resources & References

Resources for coding chondropathies include the official ICD-10 guidelines, clinical reference books, and educational materials on medical coding.

Official Guidelines:

ICD-10-CM Official Guidelines for Coding and Reporting
American Health Information Management Association (AHIMA) guidelines
Centers for Medicare & Medicaid Services (CMS) guidelines

Clinical References:

Clinical textbooks on orthopedics and rheumatology
Medical journals on chondropathies

Educational Materials:

Online courses on medical coding
Webinars on ICD-10 coding

Frequently Asked Questions

What is the difference between M91 and M94?

M91 codes are used for juvenile osteochondrosis, while M94 codes are used for other disorders of cartilage.