Medicine

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Orthopedics
Summary Discharge
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Common Pitfall

• ?????????????? principal diagnosis
• Unilateral / bilateral
• Anatomical site code
• Comorbidity Complication
• ????????????? procedure

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ICD nomenclature
Arthrosis/Osteoarthrosis Osteoarthritis (OA)
Gonarthrosis Osteoarthritis of knee
Coxarthrosis Osteoarthritis of hip
Arthropathy Arthritis
Arthrodesis Fusion of bone / joint
Pseudoarthrosis Nonunion of fracture
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• Fracture
• Joint
• Spine
• Post-operative
• Multiple Injury
• External Cause

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Fracture
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• Open Closed Fracture
• ????????? multiple fracture, wrist, Elbow,
  BB
• ?????????????????????
• ???????????????, ?????????

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! Gun shot wound Fracture Open fracture
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Operation
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Open closed reduction? Internal
fixation? Arthrodesis? Bone?? esp. Multiple
fracture Debridement Open fracture?
Soft tissue?
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S82.10 Closed fracture of upper tibia
?????????? ??????

• Op 79.3 ORIF
• RW 0.5792
• Op 79.36 ORIF tibia
• RW 1.6582

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S72.30 Fracture Shaft of femur
?????????? ??????

• Op 79.3 ORIF
• RW 0.8877
• Op 79.35 ORIF femur
• RW 2.4214

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Common miss CC

• Underling disease ??? Pt
• Vascular, nerve, tendon injury
• Other injury
• Acute hemorrhagic Anemia
• Hypo/Hyperkalemia, Electrolyte imbalance

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K-wire Fixation
79.1- Closed reduction of fracture with internal
fixation
79.3- Open reduction of fracture with internal
fixation
78.5-Internal fixation of bone without fracture
reduction
78.1- Application of external fixation device
81.25 Carporadial fusion 81.26 Metacarpocarpal
fusion
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Debridement
79.6- Debridement of open fracture site
86.28 Nonexcisional debridement of wound
Debridement NOS
86.22 Excisional debridement of wound
Removal by excision of devitalized tissue
necrosis
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JOINT
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Knee injury

• ???????????????? injury ?????????? ????
  contusion, Laceration wound, Hemathrosis,
  ligament
• ????????????? Arthroscopy

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0 Multiple sites 1 Ant cruciate ligament 2 Post
cruciate ligament 3 Med collateral ligament 4 Lat
collateral ligament (ant horn) 5 Lat collateral
ligament (post horn) 6 Lat collateral
ligament (other horn) 7 Capsular ligament 9
Unspecified
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Arthroscopy

• Joint?
• Finding - Diagnosis
• Procedure Excision?, repair?

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Inflammatory arthropathy

• Rheumatoid arthritis
• Juvenile arthritis
• Psoriasis
• Gout
• Crystal arthropathies

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RA
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Arthroplasty / Replacement
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OA Knee
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Spine
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• Anatomical site code
• Radiculopathy / Myelopathy

0 Multiple sites 1 Occipito-atlanto-axial
region 2 Cervical region 3 Cervicothoracic
region 4 Thoracic region 5 Thoracolumbar region 6
Lumbar region 7 Lumbosacral region 8 Sacral and
sacrococcygeal region 9 Unspecified
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Spondylosis

• Level
• Myelopathy / Radiculopathy

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X
HNP
Herniated Nucleus Pulposus

• Level
• Myelopathy / Radiculopathy

M51.0 Lumbar and other intervertebral disc
disorders with myelopathy (G99.2) ???? M51.1
Lumbar and other intervertebral disc disorders
with radiculopathy ???? M51.2 Other specified
intervertebral disc displacement
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injury

• ?????????????? spine
• ??????????? nerve and spinal cord injury

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Post operative
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• ???????????????? ?????????????????
  ?????????????????????? ????????????? 1 ?????
• ???? ??????? Closed fracture of shaft of
  femur ???????.????????????? ORIF 4 ???
• PDx Z54.4 Convalescence following treatment
  of fracture

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• 2. ???????????????? ??????????????????????????????
  ????????????????????
• ????????????????? (Post procedural
  disorder) ???????????????????????????????
• ????
• K91.1 Postcholecystectomy syndrome
• T81.3 Disruption of operation wound

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• ?????????????????? S/P
• ??????????????????????????? PDx

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