Pre-Existing¶
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Pre-existing Conditions
Pre-existing Conditions Overview
Osteoarthritis Upper Extremity Pre-existing Codes
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¶
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Spondylosis (arthritis) 721
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Spondylolysis 756.11
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Spondylolisthesis 738, 756.12
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Pre-existing Disc Lesions 722
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Spinal Stenosis (narrowing) 723, 724
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Degenerative Disc Disease (DDD) 722.4, 722.51, 722.52
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 715.11****
Elbow 715.12****
Wrist 715.13****
Fingers 715.14****
Symptoms for the Upper Extremity Include¶
· Effusion (swelling)
· Pain
· Stiffness
Osteoarthritis Lower Extremity Pre-Existing Codes¶
Hip 715.15****
Knee 715.16****
Ankle 715.17****
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 patellar (knee cap)
· The code is 717.7.BL/BR****
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 code is 727.51.BL/BR****
Diabetes¶
· Increases the healing time on wounds by 3-5 weeks and crush injuries by 50%
· The code is 250****
Obesity¶
· Increases the healing time of thoracic, lumbar and lower extremity injuries by 25%
· The code is 278****