Question 1

Examples of active treatment are surgical treatment, emergency department encounter, and evaluation and continuing treatment by the same or different provider. Cast change is considered subsequent treatment.

Question 2

Rationale:

According to ICD-10-CM guideline I.C.13.a.1, Bone versus joint For certain conditions, the bone may be affected at the upper or lower end, (e.g., avascular necrosis of bone, M87, Osteoporosis, M80, M81). Though the portion of the bone affected may be at the joint, the site designation will be the bone, not the joint.

Question 3

Rationale:

According to ICD-10-CM guideline I.C.13.d

The site codes under category M80, Osteoporosis with current pathological fracture, identify the site of the fracture, not the osteoporosis.

Question 4

Rationale:

ICD-10-CM Alphabetic Index> Degeneration, degenerative > Intervertebral disc NOS > lumbar region > M51.36.

ICD-10-CM Alphabetic Index: Degeneration, degenerative > Intervertebral disc NOS > lumbosacral region > M51.37.

Verify code selection in the Tabular List.

The low back pain is a symptom of the degenerative disc disease and is not reported separately.

Question 5

Rationale:

ICD-10-CM Alphabetic Index: Foreign body > in > soft tissue (residual) > M79.5. Look for ICD-10-CM Alphabetic Index: Laceration > forehead > foreign body > S01.82-. The 6th character is X and the 7th character is S for the sequela.

Next, report the type of foreign body.

ICD-10-CM Alphabetic Index: Foreign Body > Retained (old) (nonmagnetic) (in) > Fragments > “see” Retained > foreign body fragments (type of).

ICD-10-CM Alphabetic Index: Retained > foreign body fragments (type of) > Metal > Z18.10.

Verify code selection in the Tabular List. There is no mention of whether the metal is magnetic or not. The patient did not have an acute laceration with a foreign body in an open wound; therefore, code S01.82XA is not reported.

ICD-10-CM coding guideline I.B.10 indicates: A sequela is the residual effect (condition produced) after the acute phase of an illness or injury has been terminated. Coding sequela generally requires two codes sequenced in the following order: the condition or nature of the sequela is sequenced first. The sequela code is sequenced second.

Question 6

Rationale:

ICD-10-CM Alphabetic Index: Arthritis, arthritic > Degenerative > “see” Osteoarthritis.

Osteoarthritis > primary > knee > M17.1-.

A 4^th character is required to report the laterality.

Report code M17.12 for left knee.

You do not report the ICD-10-CM code for knee pain as this is a symptom of the degenerative arthritis and is not reported separately.

Question 7

Rationale:

According to ICD-10-CM guideline I.C.13.d.2

A code from category M80, not a traumatic fracture code, should be used for any patient with known osteoporosis who suffers a fracture, even if the patient had a minor fall or trauma, if that fall or trauma would not usually break a normal, healthy bone.

Question 8

ICD-10-CM Alphabetic Index: Fracture > pathological (pathologic) > due to osteoporosis > specified cause NEC – “see” Osteoporosis > specified type NEC > with > pathological fracture.

Osteoporosis (female) (male) > senile – see Osteoporosis, age-related, with current pathologic fracture > Vertebra(e) > M80.08XA

Review Tabular for complete code assignment.

Rationale: In ICD-10-CM, a combination code is utilized to report osteoporosis with an associated pathological fracture. When identifying senile osteoporosis, the code book directs the coder to age-related osteoporosis.