Chapter 8 - Musculoskeltal System Flashcards
Flexor muscle
Causes flexion, bending of a limb or body part
Extensor muscle
Causes straightening of a limb or body part
Adductor muscle
Moves a body part towards the midline of the body
Abductor
Moves a body part away from the midline of the body
Pronator muscle
Turns a part downward or backwards by rotating
Supinator muscle
Turns a part upward or forward by rotation
Colle’s fracture
Fracture of the wrist at the distal radius. Sometimes the ulnar styloid is also involved
Smith’s fracture
Similar to colle’s fracture but the bones are displaced toward the palm.
Jones fracture
Stress fracture of the fifth metatarsal of the foot
Salter-Harris fracture
An epiphyseal plate fracture. Common injury in children
Dupuytren’s fracture
Fracture of the distal fibula with rupture of the distal tibiofibular ligaments and lateral displacement of the talus.
Monteggia’s fracture
Fracture of the proximal third of the ulna with associated dislocation of the radial head.
Main ICD chapters for musculoskeletal system
Chapter 13 Diseases of the Musculoskeletal System, Chapter 18 Signs, Symptoms, Abnormal Clinical Findings, Chapter 19 Injury, Poisoning, and other consequences of external causes.
Arthropathies
Arthropathy is a pathology or abnormality of a joint. Arthritis conditions are listed here. Verify if underlying disease is also coded.
Rheumatoid arthritis
Autoimmune disease involving the joints. Coded based on presence with other conditions like splenoadenomegaly, lung disease, presence of rheumatoid factor. Symmetrical inflammation
Osteoarthritis
Most common joint disorder. Gradual onset of pain, stiffness, and swelling. Documentation must include whether it’s primary, secondary, post traumatic, site, and laterality.
Bucket handle tear
Inside portion of a meniscus tears off but the sides stay attached creating what looks like a bucket handle.
Systemic Lupus Erythematosus
Lupus. Autoimmune inflammatory connective tissue disease that affects multiple body systems. Most common in women with no known cause. Manifestations are included in the code
Spondylosis
Osteoarthritis of the spine.
Spondylitis
Inflammation of the spine
Ankylosis
Stiffening of a joint
Ankylosing spondylitis
Stiffening and inflammation of the spine. More common in men than women.
Spinal stenosis
Narrowing of the spinal canal. Causes pressure on the nerves causing pain, paresthesia, weakness, or diminished reflexes. Coded based on region of the spine. Neurogenic claudication is included in this code
Neurogenic claudication
Pain in the lower back, buttock, thigh, and leg. Precipitated by walking and prolonged standing. Relieved by change in position or flexion of the waist and not by rest.
Rheumatism
Nonspecific reference to any painful disorder of joints, muscle, or connective tissue. Codes from M65-M67
Synovitis
Condition that causes joint tenderness and swelling. Can be very painful. Synovial lining becomes inflamed.
Tenosynovitis
When the protective lining of the tendon sheath becomes inflamed.
Trigger finger
Condition that causes the finger to snap straight when extending the hand.
Ganglion of the joint or tendon
Benign cyst that occurs above a tendon or on a joint. Most common in the hands and wrist.
Capsulitis
Inflammation of the tissues surrounding a joint.
Adhesive capsulitis
Reduction in mobility of the shoulder. Often called frozen shoulder.
De Quervain’s Syndrome
Radial styloid tenosynovitis. Caused by repetitive motion of the wrist.
Bursitis
Inflammation of the bursa.
Compartment syndrome
Compression of the nerves, muscles, and blood vessels in an enclosed space. Can be traumatic and non traumatic.
Osteomyelitis
Inflammation of the bone and bone marrow caused by infection. Based on acute, subacute, chronic, and by site and laterality. Need to code infectious agent and major osseous effect.
Osteochondrosis
Causes degeneration of ossification centers of the epiphyses of the bone. Often seen in children experiencing periods of rapid growth.
Osteoporosis
Bone disease that decreases bone density. Coded based on type, and with or without pathologic fracture.
Pathologic fracture
Fracture caused by disease such as an infection or tumor leading to weakness in the bone. Most often osteoporosis. Verify if codes are needed for underlying condition.
Lordosis
Curving of the lumbar spine
Kyphosis
Curving of the thoracic spine.
Scoliosis
Curvature of the spine to the left or right.
Sprain
Involves non-contractile tissue (ligaments)
Strain
Involves contractile tissue (muscle and tendons)
Nursemaid’s elbow
Partial dislocation of the elbow, or proximal radial head dislocation. Seen in children and caused by sudden pull on child’s arm or hand.
Closed fracture
Bone has not broken the skin. Unspecified fractures are coded as closed
Open fracture
Fracture where the bone has broken through the skin.
Comminuted fracture
Bone is crushed or splintered into several pieces.
Compression impacted fracture
Bone is compressed into another bone caused by trauma or osteoporosis. Common in the vertebrae.
Depressed fracture
Fracture typically resulting from blunt force trauma to the skull. Portion of the bone is pushed in.
Greenstick fracture
Bone is broken on one surface and bent on the other. Like a green twig when bent. Occurs in children before bones have hardened.
Impacted fracture
One part of the bone is driven forcefully into another.
Simple fracture
Fracture in only one place.
Torus or incomplete fracture
One side of the bone buckles. Common in children.
Terms that may indicate an open fracture
Compound, infected, missile, puncture, with foreign body.
Displaced vs non displaced fracture
If not specified fracture is coded as displaced. Displaced is when the bones no longer line up.
Gustilo Classification of open fractures
Based on type. I - III with subcategories for IIIA - IIIC. Used to measure severity of the fracture.
AC
Acromioclavicular
AKA
Above knee amputation
BKA
Below knee amputation
CMC
Carpometocarpal joint
CTS
Carpel tunnel syndrome
DDD
Degenerative disk disease
DJD
Degenerative joint disease
FROM
Full range of motion
FX
Fracture
FWB
Full weight bearing
LT
Left side
ORIF
Open reduction internal fixation
ROM
Range of motion
SI
Sacroiliac joint
THR
Total hip replacement
UE
Upper extremity
Manipulation of a fracture
Attempted reduction or restoration of a fracture or joint dislocation to its normal anatomic alignment of manually applied forces
Fixation of a fracture
Internal or external. Maintain the alignment of the bone while it heals. Pins, screws, rods, plates, wires, etc.
Closed treatment
Fracture or dislocation treated without an incision. Three types of closed treatment. With or without manipulation, and with or without the application of traction.
Closed treatment without manipulation
Simple immobilization using a cast, splint, or similar device. May be called skin traction in documentation. Skin traction is application of longitudinal application of force to a bone using felt or strapping applied directly to the skin.
Closed treatment with manipulation
When bone ends do not align and must be manipulated back to alignment. Riskier procedures. May include traction
Open treatment and reduction of a fracture/dislocation
When unable to manipulate a fracture back without surgery to open and visualize the fracture before fixation.
Percutaneous skeletal fixation
Neither open nor closed treatment. Often stab wounds via X-ray to place screws or pins before a cast, brace, or splint is applied.
Coding repeat reduction of a fracture/dislocation
When repeat treatment by a same doctor is needed for the same injury use modifier 58.
Excision of muscle or bone
Verify if deep or superficial excision
Arthrogram
X-ray of a joint after injecting contrast material. Coded by anatomical site.
Trigger point
Area of the body very tender or painful when touched or pressure is applied.
Trigger point injections
Coded by number of muscles receiving injection(s) and not the number of injections.
Dry needling
Needle is inserted with no medication or solution injected into the muscle. Used to increase range of motion or alleviate pain. Coded by number of muscles not number of needles inserted.
Arthrocentesis
Puncture of a joint with a large diameter needle for fluid removal or injection. Verify if image guided. Does not include the drug if injected. Code drug separately.
Replantation
Replacing a digit or limb after complete amputation. If partially amputated use code for specific repair.
Morselized bone
Bone in particle form for spine procedures
Monocortical
Graft of cortical bone removed from the outer cortex of the ilium
Bicortical
Graft of cortical bone removed as one piece from the inner and outer portions of the ilium and removed as one piece.
Tricortical
Graft of cortical bone from the ilium that includes the anterior-superior iliac spine and both the inner and outer iliac cortex removed as one piece
Graft codes
Used for autogenous bone, cartilage, tendon or fascia lata grafts, or other tissue via separate incisions. Verify if bone graft is included in the procedure code.
“With grafting”
Refers to the placement of a graft. If a graft is obtained from a separate incision and not included code for the harvesting of the graft. If used implies a graft was used.
Interstitial fluid pressure monitoring
Method of detecting muscle compartment syndrome. Monitoring device is inserted into the muscle compartment, data is collected and then the device is removed.
Microsurgery
Other procedure codes. Includes anastomosis of vessels less than 2mm in diameter and individual nerve fibers. Includes transfer from fibula, rib or other bones. Verify location.
Vascularized bone graft
Other procedure used when large defects exist, usually in long bones, where standard iliac grafts or other types of non-vascularized bone grafts are not likely to heal.
Free osteocutaneous flaps
With microvascular anastomosis. Used with reconstructive surgery. For repair is bone and overlying soft tissue. Includes use of operating microscope.
Percutaneous radiofrequency ablation
Alternative to or supplement for radiation therapy of metastatic lesions to the bone for a variety of primary tumors.
LeFort Procedures
Mid face. Three lines of typical weakness. Do not confuse reconstruction procedures with fracture care codes of LeFort injuries.
LeFort I
Horizontal fracture of the mid face typically above apices of the teeth
LeFort II
Fracture traverses the mid face and meets at the apex of the nose. Pyramid shaped.
LeFort III
Facial bones become separated from the cranial bones. Runs from ear to ear through the bony orbit of the eye.
Hyoid myotomy and suspension
Used to treat sleep apnea. Opens the orohypopharyngeal airway. Also called modified hyoid myotomy and suspension with hyoid repositioning. Code 21685
Vertebroplasty
Percutaneously creating a cavity in the bone and injecting bone cement to provide stability to the vertebra preventing further vertebral collapse. Codes based on area of spine involved.
Kyphoplasty
Vertebral augmentation. Used to stabilize a spinal compression fracture. Cavity created to restore the height of the vertebra. Bone cement is injected to stabilize the area to reduce pain and prevent collapse.
Arthrodesis
Surgical immobilization of a joint. Bone fusion. Cortical bone graft is packed in to promote growth of new bone cells. Common on ankles, wrist and spine.
Spinal instrumentation
Segmented or non-segmented and anterior or posterior. Used to treat abnormal spinal curvature, fracture, or dislocation. Add on codes to primary procedure.
Segmental fixation
Fixation at each end of the construct with at least one additional interposed bony attachment.
Non-segmental fixation
Fixation at each end of the construct and may span several vertebral segments without attaching to intervening segments.
Shoulder bones
Scapula, acromion, and clavicle
Extra-articular
Performed on the outer portion of a movable joint
Intra-articular
Procedure performed on the inner portion of a movable joint
Total hip arthroplasty
Both articular surfaces of the acetabulum and femur are replaced.
Hemiarthroplasty
Femoral head is replaced and the acetabulum is not altered.
Mosaicplasty
Procedure where cylindrical osteochondral grafts are removed and transplanted to holes prepared at the recipient site. Coded by open incision or arthroscopy
