humeral avascular necrosis and osteoarthritis
Would love input on a case where a Pt. has diagnosed osteoarthritis of the shoulder per H+P. The op report for the replacement of the humeral head and neck says significant osteoarthritis. The pathology report says osteoarthritis shoulder. The discharge summary by the same provider that did the H+P says admit and dc diagnosis avn.
If the osteoarthritis of the shoulder is principal diagnosis and the avn is coded as an additional diagnosis the avn is a cc. If the avn is principal diagnosis and the osteoarthritis is coded as an additional code there is no cc.
From my research it appears that avn can result in osteoarthritis. I can't really find any information that the reverse is true. I can't find any edits or coding clinics on this.
Any thoughts on how this should be sequenced? Or should only one of the conditions be used? Thanks for your help.
If the osteoarthritis of the shoulder is principal diagnosis and the avn is coded as an additional diagnosis the avn is a cc. If the avn is principal diagnosis and the osteoarthritis is coded as an additional code there is no cc.
From my research it appears that avn can result in osteoarthritis. I can't really find any information that the reverse is true. I can't find any edits or coding clinics on this.
Any thoughts on how this should be sequenced? Or should only one of the conditions be used? Thanks for your help.
Comments
http://www.uptodate.com/contents/osteonecrosis-avascular-necrosis-of-bone?detectedLanguage=en&source=search_result&search=avascular+necrosis&selectedTitle=1~150&provider=noProvider
http://www.uptodate.com/contents/search?search=osteoarthritis&sp=0&searchType=PLAIN_TEXT&source=USER_INPUT&searchControl=TOP_PULLDOWN&searchOffset=
Sharon Salinas, CCS
I am not clear on what AVN is. avascular necrosis?
Mary A Hosler, RN, MSN
Clinical Documentation Specialist
Alumnus CCRN
McLaren Bay Region
1900 Columbus Ave.
Bay City, Michigan 48708
(989) 891-8072
mary.hosler@mclaren.org
"The difference between the right word and the almost right word is the
difference between lightning and the lightning bug."- Samuel "Mark
Twain" Clemens
Wow, do I feel silly....laughing at myself....
Mary A Hosler, RN, MSN
Clinical Documentation Specialist
Alumnus CCRN
McLaren Bay Region
1900 Columbus Ave.
Bay City, Michigan 48708
(989) 891-8072
mary.hosler@mclaren.org
"The difference between the right word and the almost right word is the
difference between lightning and the lightning bug."- Samuel "Mark
Twain" Clemens