Treatment of Accidental Injury to the Spine and BackCare Path Diagnosis Coding |
The following International Classification of Diseases, 9th Revision Clinical Modification - fifth edition ICD-9-CM diagnostic codes are associated with Care Path 1 through Care Path 6 for treatment of Accidental Injury to the Spine and Back and are included on each appropriate Care Path. The ICD9 codes referenced do not include codes for multiple diagnoses or co-morbidity. Care Path 728.0 Disorders of muscle, ligament and fascia 1 728.85 Spasm of muscle 739.0 Non allopathic lesions - not elsewhere classified 739.1 Somatic dysfunction of cervical region 847.0 Sprains and strains of neck 847.9 Sprains and strains of back, unspecified site 922.3 Contusion of back 922.31 Contusion of back, excludes interscapular region 953.0 Injury to cervical root Care Path 722.0 Displacement of cervical intervertebral disc without myelopathy 2 722.2 Displacement of intervertebral disc, site unspecified, without myelopathy 722.70 Intervertebral disc disorder with myelopathy, unspecified region 722.71 Intervertebral disc disorder with myelopathy, cervical region 728.0 Disorders of muscle, ligament and fascia 739.0 Non allopathic lesions - not elsewhere classified 953.0 Injury to cervical root Care Path 728.0 Disorders of muscle, ligament and fascia 3 728.85 Spasm of muscle 739.0 Non allopathic lesions - not elsewhere classified 739.2 Somatic dysfunction of thoracic region 739.8 Somatic dysfunction of rib cage 847.1 Sprains and strains, thoracic 847.9 Sprains and strains of back, unspecified site 922.3 Contusion of back 922.33 Contusion of back, interscapular region Care Path 722.0 Displacement of cervical intervertebral disc without myelopathy 4 722.1 Displacement of thoracic or lumbar intervertebral disc without myelopathy 722.11 Displacement of thoracic intervertebral disc without myelopathy 722.2 Displacement of intervertebral disc, site unspecified, without myelopathy 722.70 Intervertebral disc disorder with myelopathy, unspecified region 722.72 Intervertebral disc disorder with myelopathy, thoracic region 728.0 Disorders of muscle, ligament and fascia 739.0 Non allopathic lesions - not elsewhere classified Care Path 728.0 Disorders of muscle, ligament and fascia 5 728.85 Spasm of muscle 739.0 Non allopathic lesions - not elsewhere classified 739.3 Somatic dysfunction of lumbar region 739.4 Somatic dysfunction of sacral region 846 Sprains and strains of sacroiliac region 846.0 Sprains and strains of lumbosacral (joint) (ligament) 846.1 Sprains and strains of sacroiliac ligament 846.2 Sprains and strains of sacrospinatus (ligament) 846.3 Sprains and strains of sacrotuberous (ligament) 846.8 Sprains and strains of other specified sites of sacroiliac region 846.9 Sprains and strains, unspecified site of sacroiliac region 847.2 Sprains and strains, lumbar 847-3 Sprains and strains, sacrum 847.4 Sprains and strains, coccyx 847.9 Sprains and strains, unspecified site of back 922.3 Contusion of back 922.31 Contusion of back, excludes interscapular region 953.2 Injury to lumbar root 953.3 Injury to sacral root Care Path 722.1 Displacement of thoracic or lumbar intervertebral disc without myelopathy 6 722.10 Displacement of lumbar intervertebral disc without myelopathy 722.2 Displacement of intervertebral disc, site unspecified, without myelopathy 722.70 Intervertebral disc disorder with myelopathy, unspecified region 722.73 Intervertebral disc disorder with myelopathy, lumbar region 728.0 Disorders of muscle, ligament and fascia 739.0 Non allopathic lesions - not elsewhere classified 953.3 Injury to sacral root The following ICD-9-CM supplemental classification of external causes of injury may be used in addition to the specific diagnostic codes noted above and on each Care Path:
These codes may be used to indicate cause of injury as motor vehicle accident but should not be used without an associated diagnostic code. ADDENDUM TO CARE PATHS 1. Medications Muscle Relaxants
Opioid Analgesics
Oral Steroids
2. Who May Perform Spinal Manipulation: Spinal manipulation may be performed by those providers licensed or certified to perform this procedure within their scope of practice. 3. Spinal Manipulation/Chiropractic Care A course of spinal manipulation/chiropractic care may be considered as conservative therapy on all Care Paths. If there is no improvement within one month, then immediate reevaluation is indicated to determine appropriate further treatment and treatment options, including referral to other health care providers and/or modification of conservative therapy.. When findings suggest progressive or severe neurologic deficits, an appropriate diagnostic assessment to rule out serious neurologic conditions is indicated in any conservative therapy. 4. Mental Health/Rehabilitation Assessment Option If Patient Has Not Responded To Treatment A mental health/rehabilitation assessment can be obtained if psychological/ psychosocial or psychiatric distress is obvious from the history, i.e., presence of "non-organic" physical signs, repetitive back injuries, failed previous treatments, litigation or disability compensation claims, family or financial problems, apparent secondary gain, boredom and dissatisfaction with job, frequent bouts of pain, depression, alcohol and substance abuse, extreme obesity, and apparent psychiatric behavior. |
Published: May 21, 1999 Amended: November 29, 2000 |