ICD Code M19.90

ICD code M19.90 is used to identify a diagnosis of unspecified osteoarthritis at an unspecified site. This code is applied when a patient has osteoarthritis, a degenerative joint disease characterized by the breakdown of joint cartilage and underlying bone, but the specific location of the condition is not detailed in the medical documentation. It is a non-specific code that helps healthcare providers document the presence of osteoarthritis when the exact joint or area affected is not specified.

1. Presence of Joint Pain: The patient reports persistent or intermittent pain in one or more joints, which may worsen with activity or improve with rest.

2. Joint Stiffness: The patient experiences stiffness in the affected joint(s), particularly noticeable in the morning or after periods of inactivity.

3. Swelling or Tenderness: There is observable swelling or tenderness in the joint(s), which may be accompanied by warmth or redness.

4. Reduced Range of Motion: The patient has a noticeable decrease in the ability to move the affected joint(s) through its full range of motion.

5. Crepitus: The presence of a grating sensation or sound when the joint is moved, indicating possible cartilage wear.

6. Radiographic Evidence: Imaging studies, such as X-rays, show characteristic changes associated with osteoarthritis, such as joint space narrowing, osteophyte formation, or subchondral sclerosis.

7. Exclusion of Other Conditions: Other potential causes of joint symptoms, such as rheumatoid arthritis, gout, or infectious arthritis, have been ruled out through clinical evaluation and diagnostic testing.

8. Chronicity of Symptoms: The symptoms have been present for an extended period, typically several months, and are not attributable to an acute injury or transient condition.

9. Age Factor: The patient is typically middle-aged or older, as osteoarthritis is more common in this demographic, although it can occur in younger individuals with predisposing factors.

10. Impact on Daily Activities: The joint symptoms significantly affect the patient's ability to perform daily activities, contributing to a decreased quality of life.

For the ICD code M19.90, which pertains to unspecified osteoarthritis at an unspecified site, the relevant CPT codes that may be applicable for treatment include:

1. 20610 - Arthrocentesis, aspiration, and/or injection into a major joint or bursa (e.g., knee, hip, shoulder joint); without ultrasound guidance.

2. 20611 - Arthrocentesis, aspiration, and/or injection into a major joint or bursa (e.g., knee, hip, shoulder joint); with ultrasound guidance.

3. 99213 - Established patient office or other outpatient visit, typically 15 minutes.

4. 99214 - Established patient office or other outpatient visit, typically 25 minutes.

5. 97035 - Application of a modality to one or more areas; ultrasound, each 15 minutes.

6. 97110 - Therapeutic exercises to develop strength and endurance, range of motion, and flexibility (each 15 minutes).

7. 97140 - Manual therapy techniques (e.g., mobilization/manipulation, manual lymphatic drainage, manual traction), one or more regions, each 15 minutes.

8. J7321 - Hyaluronan or derivative, Hyalgan or Supartz, for intra-articular injection, per dose.

These CPT codes represent a range of potential treatments and services that may be utilized in managing unspecified osteoarthritis, depending on the specific clinical scenario and treatment plan determined by the healthcare provider. Always ensure that the chosen CPT codes align with the specific services provided and are supported by appropriate documentation.

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