Pre-existing¶
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Pre-existing Conditions
Pre-existing Conditions Overview
Osteoarthritis Upper Extremity Pre-existing Codes
· Shoulder
· Elbow
· Wrist
· Fingers
Osteoarthritis Lower Extremity Pre-existing Codes
Pre-existing Conditions Overview¶
· The system covers pre-existing conditions to the spine and joints and also covers pre-existing diabetes and obesity
· Pre-existing codes increase the healing time thereby increasing the General Damages
· When utilizing the pre-existing codes make sure that the pre-existing condition the individual is diagnosed with has been ‘ aggravated ’ by the accident
· Pre-existing conditions should only be added if there is medical documentation that supports they were aggravated from the accident, many times an MRI of the spine may reveal spondylosis, DDD, or a pre-existing disc lesion(s) or stenosis; these should only be added when the medical doctor states aggravation or exacerbation of the underlying condition has occurred
· The number and type of symptoms associated with the pre-existing code can increase the healing time
· When multiple symptoms are selected, the system will assess using the symptom with the highest severity
Spine Pre-existing codes¶
When searching on these root codes be sure to select the Option Type of "Pre-existing" to narrow the search results
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Spondylosis (arthritis) M47.81
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Spondylolysis M43.07
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Spondylolisthesis M43.17
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Pre-existing Disc Lesions M5
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Spinal Stenosis (narrowing) M48
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Degenerative Disc Disease (DDD) M50.3 (cervical)/M51.3 (thoracic/lumbar)
Symptoms for Spine¶
Three Symptoms are included for the Cervical and Lumbar Spine :
· Bilateral Radiculitis
· Unilateral Radiculitis
· Pain
Osteoarthritis Upper Extremity Pre-Existing Codes¶
Shoulder M19.01
Elbow M19.02
Wrist M19.03
Fingers M19.04
Symptoms for the Upper Extremity Include¶
· Effusion (swelling)
· Pain
· Stiffness
Osteoarthritis Lower Extremity Pre-Existing Codes¶
Hip M16.1
Knee M17.1
Ankle/Foot/Toes M19.07
Symptoms for the Lower Extremity include¶
· Limp
· Effusion (swelling)
· Pain
· Stiffness
· Crepitus (joint grinding)
Chondromalacia of the knee joint¶
· Degeneration of the articular cartilage of the knee joint in the region of the underside of the patella (knee cap)
· The root code is M22.4
Popliteal cyst (baker’s cyst) { #Popliteal_cyst(baker’s }¶
· A cyst in the back of the knee, arising from the joint capsule of the sheaths of the tendon
· The root code is M71.2
Diabetes¶
· Increases the healing time on wounds by 3-5 weeks and crush injuries by 50%
· The code is E10
Obesity¶
· Increases the healing time of thoracic, lumbar and lower extremity injuries by 25%
· The code is E66.9