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v1.0.0
ICD-10 Guide
ICD-10 CodesQ78.0

Q78.0

Billable

Osteogenesis imperfecta

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/11/2025

Code Description

ICD-10 Q78.0 is a billable code used to indicate a diagnosis of osteogenesis imperfecta.

Key Diagnostic Point:

Osteogenesis imperfecta (OI) is a genetic disorder characterized by fragile bones that break easily, often with little or no apparent cause. This condition is caused by a defect in the production of collagen, a protein that helps strengthen bones. OI can manifest in various forms, ranging from mild to severe, with symptoms including frequent fractures, blue sclera, hearing loss, and dental imperfections. The severity of OI is influenced by the specific genetic mutation involved, with some individuals experiencing only a few fractures in their lifetime while others may have hundreds. In pediatric patients, the diagnosis is often made based on clinical findings, family history, and genetic testing. Management of OI typically involves a multidisciplinary approach, including orthopedic care, physical therapy, and sometimes surgical interventions to correct deformities or stabilize fractures. Understanding the complexities of OI is crucial for accurate coding and appropriate management of affected individuals.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in clinical presentation and severity of the condition.
  • Need for genetic testing documentation to confirm diagnosis.
  • Potential for co-morbid conditions that may complicate coding.
  • Differentiation from other skeletal dysplasias and congenital conditions.

Audit Risk Factors

  • Inadequate documentation of genetic testing results.
  • Failure to specify the severity of the condition.
  • Misclassification of OI with other skeletal disorders.
  • Lack of comprehensive treatment documentation.

Specialty Focus

Medical Specialties

Pediatrics

Documentation Requirements

Detailed history of fractures, growth patterns, and family history of OI.

Common Clinical Scenarios

Pediatric patients presenting with multiple fractures or deformities requiring orthopedic intervention.

Billing Considerations

Consideration of age-related factors in fracture management and growth monitoring.

Genetics

Documentation Requirements

Genetic testing results, family pedigree, and detailed clinical findings.

Common Clinical Scenarios

Genetic counseling sessions for families with a history of OI or suspected cases.

Billing Considerations

Understanding the inheritance patterns and implications for family members.

Coding Guidelines

Inclusion Criteria

Use Q78.0 When
  • Follow the official ICD
  • CM guidelines for coding congenital conditions, ensuring accurate documentation of the diagnosis, severity, and any associated conditions

Exclusion Criteria

Do NOT use Q78.0 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

20610CPT Code

Arthrocentesis, aspiration and/or injection into a major joint or bursa

Clinical Scenario

Used in conjunction with OI management for joint issues.

Documentation Requirements

Document the joint involved and reason for the procedure.

Specialty Considerations

Orthopedic specialists may frequently perform this procedure.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of osteogenesis imperfecta, enabling better tracking of the condition's prevalence and management outcomes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of osteogenesis imperfecta, enabling better tracking of the condition's prevalence and management outcomes.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of osteogenesis imperfecta, enabling better tracking of the condition's prevalence and management outcomes.

Resources

Clinical References

  • •
    Osteogenesis Imperfecta Foundation

Coding & Billing References

  • •
    Osteogenesis Imperfecta Foundation

Frequently Asked Questions

What is the primary cause of osteogenesis imperfecta?

Osteogenesis imperfecta is primarily caused by genetic mutations affecting collagen production, leading to fragile bones.