humeral avascular necrosis and osteoarthritis

jpotterjpotter
in CDI Talk Archive
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.

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