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v1.0.0
ICD-10 Guide
ICD-10 CodesQ78.1

Q78.1

Billable

Polyostotic fibrous dysplasia

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

Code Description

ICD-10 Q78.1 is a billable code used to indicate a diagnosis of polyostotic fibrous dysplasia.

Key Diagnostic Point:

Polyostotic fibrous dysplasia is a rare congenital disorder characterized by the replacement of normal bone with fibrous tissue, leading to structural weakness and deformities. This condition can affect multiple bones (polyostotic) and is often associated with other abnormalities, such as skin pigmentation changes and endocrine dysfunction. In children, it may present with pain, fractures, and deformities in the musculoskeletal system, including scoliosis and limb length discrepancies. Diagnosis is typically made through imaging studies, such as X-rays or MRI, which reveal characteristic lesions. Management may involve orthopedic interventions, pain management, and monitoring for complications. The condition can also be part of McCune-Albright syndrome, which includes additional features such as precocious puberty and café-au-lait spots. Accurate coding is essential for appropriate treatment and management of associated conditions.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in clinical presentation and severity of the condition.
  • Potential association with other congenital syndromes.
  • Need for detailed imaging and documentation to support diagnosis.
  • Differentiation from other bone disorders such as osteogenesis imperfecta.

Audit Risk Factors

  • Inadequate documentation of clinical findings.
  • Failure to document associated conditions or syndromes.
  • Misinterpretation of imaging results leading to incorrect coding.
  • Inconsistent coding practices across different healthcare settings.

Specialty Focus

Medical Specialties

Pediatrics

Documentation Requirements

Detailed growth and development assessments, imaging results, and treatment plans.

Common Clinical Scenarios

Children presenting with bone pain, fractures, or deformities requiring orthopedic evaluation.

Billing Considerations

Consideration of growth patterns and potential impact on future development.

Genetics

Documentation Requirements

Genetic testing results, family history, and any syndromic associations.

Common Clinical Scenarios

Cases where fibrous dysplasia is part of a genetic syndrome requiring counseling.

Billing Considerations

Understanding the genetic basis and implications for family members.

Coding Guidelines

Inclusion Criteria

Use Q78.1 When
  • Follow official ICD
  • 10 guidelines for coding congenital malformations, ensuring accurate documentation of the condition's complexity and any associated anomalies

Exclusion Criteria

Do NOT use Q78.1 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 for pain management in patients with joint involvement due to fibrous dysplasia.

Documentation Requirements

Document the indication for the procedure and any imaging findings.

Specialty Considerations

Orthopedic specialists may 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 congenital conditions, improving the accuracy of diagnoses and treatment plans for conditions like polyostotic fibrous dysplasia.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of congenital conditions, improving the accuracy of diagnoses and treatment plans for conditions like polyostotic fibrous dysplasia.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of congenital conditions, improving the accuracy of diagnoses and treatment plans for conditions like polyostotic fibrous dysplasia.

Resources

Clinical References

  • •
    Fibrous Dysplasia Foundation

Coding & Billing References

  • •
    Fibrous Dysplasia Foundation

Frequently Asked Questions

What are the common symptoms of polyostotic fibrous dysplasia?

Common symptoms include bone pain, deformities, fractures, and in some cases, skin pigmentation changes associated with McCune-Albright syndrome.