ICD-10-CM Basics for Orthopaedics

Marissa Clemmer, CPC, CCS, CPMA, CPB, CANPC, CPEDC
Karen Zupko and Associates, Inc.

In the July 2024 AAOS Now practice management article, “ICD-10-CM Basics for Orthopaedics,” Marissa Clemmer, CPC, CCS, CPMA, CPB, CANPC, CPEDC, outlines why diagnosis coding accuracy is critical to orthopaedic practices. The article explains how ICD-10-CM codes support medical necessity, reimbursement, patient complexity, and clinical research, and clarifies the distinction between CPT codes, which describe services performed, and ICD-10-CM codes, which explain why those services were provided.

The article emphasizes the importance of clear, specific documentation, particularly as practices increasingly rely on EMRs and AI-assisted coding tools. Key areas of focus include laterality, acuity, injury status, comorbidities, social determinants of health, and proper use of seventh characters and Z codes. The article also highlights the ICD-10-CM chapters most relevant to orthopaedics and reinforces the need to follow official guidelines, indexes, and tabular lists when selecting diagnosis codes.

This article serves as a practical refresher for orthopaedic professionals and underscores the need for ongoing education, internal audits, and regular system updates to stay current with annual and interim ICD-10-CM changes.

Read the full article on AAOS Now: