DIAGNOSIS CODES (ICD-9) COMMONLY USED IN THE CHIROPRACTIC OFFICE
 
   

Diagnosis Codes (ICD-9) Commonly
Used in the Chiropractic Office

This section was compiled by Frank M. Painter, D.C.
Send all comments or additions to:
  Frankp@chiro.org

This is a cross-section of the ICD-9 Codes commonly used in chiropractic offices, listed by body region and complaint. These codes were compiled from the International Classification of Diseases 9th Revision by PMIC.

ICD-9 codes not listed on this page may be found at   FlashCode.   (A Very Useful FREE Tool)



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This is the cover letter we send insurers, along with the full diagnosis, so they will understand our use of the codes, and what it is we are describing. If this is of value to you, please feel free to use it. Enjoy!!!
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"Chiropractors describe 5 components of the Vertebral Subluxation Complex:

Kinesiopathology, or loss of alignment and/or motion irregularities (the 739 and 839 and the 737 ICD-9-CM codes),

Neuropathology, which occur due to compressed or facilitated nerve tissue (the 722-24, 353 ICD-9-CM codes),

Myopathology, or soft tissue changes due to muscle and ligament damage, involving spasm, muscle weakness/atrophy and development of myofascial disorders (the 728-29, 847 ICD-9-CM codes),

Histopathology, or the pre- and post- inflammatory changes that result as sequela to the primary soft tissue damage, progressing from edema to congestion of those tissues, and to their eventual remodelling (the 719, 782 ICD-9-CM codes), and

Pathophysiology, or the degeneration and/or fibrous tissue formation which are the inevitable outcomes of poor management of the other components (the 732-39, 723 ICD-9-CM codes).

Simply put, following macro-trauma, or repeated micro-trauma, there is a loss of normal vertebral and/or peripheral joint motion, with a loss of normal joint play.   This combines with changes in soft tissue flexibility, complicated by muscle imbalances, to create abnormal motion patterns.   The modified output from peripheral joint and muscle receptors leads to changes in central neuronal output.   This can lead to sustained abnormal motion patterns, with consequent increased stresses on those tissues.   The eventual outcome is biochemical changes in the tissues at the local cellular level, formations of adhesions, shortening and/or atrophy of support and motion structures, all which in turn may cause pain, and lead to degeneration of the vertebral segments, discs and posterior joints.

Added to this is the complicator:   connective tissue, and cartilage in general have no vascular supply; they pump out their waste products, and by diffusion receive their nutrition only when the joint is moving functionally.  If the joint loses significant ROM, or the patient stops moving the joint (pain avoidance behaviors) then those connective tissues begin to smother in their own waste products and those cells begin die off.   As the joint space begins to reduce, adding further compression to neurologic tissues, the body mobilizes calcium and other minerals in an attempt to stabilize the joint.   On films, these observed changes are termed arthritic changes.   Researcher Chuck Henderson, DC has published extensively about this degenarative process, suggesting that it can be halted by improved function (and motion) at those fixated (subluxated) joints.

Reduction of the Subluxation Complex improves joint function, reduces aberrant neuronal output from the "sick" fixed joints, and can halt, and even reverse the degenerative changes in these spinal tissues.
FYI:   Please read these articles:

Spinal Manipulation May Help Reduce Spinal Degenerative Joint Disease and Disability,  Part I
@   http://www.chiroweb.com/archives/12/07/12.html

and

Spinal Manipulation May Help Reduce Spinal Degenerative Joint Disease and Disability,  Part II
@   http://www.chiroweb.com/archives/12/09/11.html


Considerable research is underway to more accurately describe how the Vertebral Subluxation Complex may contribute to various organic complaints of the auditory, respiratory, cardiac, reproductive, and digestive systems.

That information is now available for your review at:


http://www.chiro.org/research/ABSTRACTS/Conditions.shtml

 
   

DIAGNOSIS CODES:



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The Cervical Spine:

The MEDICARE listings for Subluxation (the 739 series): 739.0 Occipital Subluxation (Nonallopathic Lesion) 739.1 Cervical Subluxation (Nonallopathic Lesion) 739.2 Thoracic Subluxation (Nonallopathic Lesion) 739.3 Lumbar Subluxation (Nonallopathic Lesion) 739.4 Sacrum or Coccyx Subluxation (Nonallopathic Lesion) 739.5 Pelvic (Ilia or SI) Subluxation (Nonallopathic Lesion) Personally, I prefer the 839 series: (What is an Nonallopathic Lesion?) 839.01 Subluxation of First Cervical Vertebra 839.02 Subluxation of Second Vertebra (.03 = Third, etc.) 839.08 Multiple Cervical Subluxation 722.0 Cervical Disc Disorder w/o Myelopathy 722.71 Cervical Disc Disorder with Myelopathy 723.0 Cervical Spinal Stenosis (usually Disc-related) 728.4 Ligament laxity (observed on flexion/extension films) 723.2 Cervicocranial Syndrome (Barre-Lieou syndrome; Posterior cervical sympathetic syndrome) 723.3 Cervicobrachial Syndrome (diffuse) 723.4 Brachial Neuritis; Cervical Radiculitis; Radicular Syndrome of Upper Extremity 723.5 Torticollis; Contracture of Neck 722.4 Degeneration of Cervical Disc(s) 353.2 Cervical Nerve Root Lesion 724.9 Foraminal Encroachment (Compression) of Nerve Root, Cervical 722.81 Postlaminectomy Syndrome Of Cervical Region 354.1 Median Nerve Neuritis 354.2 Ulnar Nerve Lesion 354.3 Radial Nerve Lesion 719.08 Edema of Cervical Facet Joint 719.48 Arthralgia of Cervical Spine 719.58 Stiffness of Cervical Spine 847.0 Cervical Sprain/Strain 723.2 Cervicocranial Syndrome 351.0 Bell’s Palsy 723.8 Occipital Neuralgia 723.3 Cervicobrachial Syndrome 353.0 Thoracic Outlet Syndrome 726.1 Rotator Cuff Syndrome 726.10 Supraspinatus Syndrome 354.0 Carpal Tunnel Syndrome 524.6 TMJ Dysfunction Syndrome 847.0 Acute post-traumatic torticollis DISCONTINUE USE OF: 333.83 Spasmodic Torticollis- This is generally due to hereditary CNS problems or degenerative CNS problems.

The Thoracic Spine:

839.21 Subluxation of the Thoracic Vertebrae 722.11 Thoracic Disc Disorder w/o Myelopathy 722.72 Thoracic Disc Disorder with Myelopathy 722.51 Degeneration of Thoracic Disc(s) 724.9 Foraminal Encroachment (Compression) of Nerve Root, Thoracic 722.82 Postlaminectomy Syndrome Of Thoracic Region 353.3 Thoracic Nerve Root Lesion 724.4 Thoracic Or Lumbosacral Neuritis Or Radiculitis 719.08 Edema of Thoracic Facet Joint 847.1 Thoracic Sprain/Strain 719.48 Arthralgia of Thoracic Spine 719.58 Stiffness of Thoracic Spine

The Lumbar Spine:

839.20 Subluxation of the Lumbar Vertebrae 722.10 Lumbar Disc Disorder w/o Myelopathy 722.73 Lumbar Disc Disorder with Myelopathy 722.52 Degeneration of Lumbar Disc(s) 738.4 Spondylolysis/Spondylolisthesis (Acquired) 756.12 Spondylolysis (Congenital) 756.11 Prespondylolisthesis (Congenital) 724.3 Sciatica; Neuralgia of Sciatic Nerve 724.9 Foraminal Encroachment (Compression) of Nerve Root, Lumbar 722.83 Postlaminectomy Syndrome Of Lumbar Region 724.4 Thoracic Or Lumbosacral Neuritis Or Radiculitis 353.4 Lumbosacral Nerve Root Lesion 719.08 Edema of Lumbar Facet Joint 847.2 Lumbar Sprain/Strain 719.48 Arthralgia of Lumbar Spine 719.58 Stiffness of Lumbar Spine

The Pelvis:

839.42 Subluxation of the Sacroiliac Joint 847.3 Sacroiliac (SI) Sprain/Strain 353.1 Lumbosacral Plexus Lesion 720.2 Sacroilitis 719.08 Edema of Sacroiliac Joint 719.48 Arthralgia of Sacroiliac Joint 719.58 Stiffness of Sacroiliac Joint 839.41 Subluxation of the Coccyx 724.71 Hypermobility Of Coccyx 847.4 Coccyx Sprain/Strain 353.1 Lumbosacral Plexus Lesion

The Peripheral Joint Codes:

831.01 Anterior Subluxation of Humerus 831.02 Posterior Subluxation of Humerus 832.12 Subluxation of Elbow 833.03 Subluxation of Carpal Bone 836.53 Medial Subluxation of Tibia 836.54 Lateral Subluxation of Tibia 838.01 Subluxation of Tarsal Bone NOTE: Look for the symptom listings below Edema (719.0 codes), Arthralgia (719.4), Stiffness (719.5) and Crepitus (719.6)

Sprains and Strains of Shoulder and Upper Arm:

840.0 Acromioclavicular (joint) (ligament) 840.1 Coracoclavicular (ligament) 840.2 Coracohumeral (ligament) 840.3 Infraspinatus (muscle) (tendon) 840.4 Rotator cuff (capsule) 840.5 Subscapularis (muscle) 840.6 Supraspinatus (muscle) (tendon)

Various Other Codes:

733.1 Collapsed Vertebra 805.0 Compression Fracture (C1 or C2) 805.1 Compression Fracture (Cervical) 805.2 Compression Fracture (Thoracic) 805.4 Compression Fracture (Lumbar) 805.6 Compression Fracture (Sacrum) 381.00 Acute Nonsuppurative Otitis Media 381.10 Chronic Serous Otitis Media, Simple Or Unspecified 382.00 Acute Suppurative Otitis Media W/O Spontaneous Rupture Of Eardrum 724.9 Ankylosing Sponylitis (Ankylosis of Spine) 736.81 Acquired Unequal Leg Length 755.30 Congenital Unequal Leg Length 781.2 Abnormality of Gait (Ataxic, Paralytic, Spastic, Staggering) 719.7 Difficulty in Walking 781.3 Lack of Coordination 781.9 Abnormal Posture 737.10 Kyphosis (Acquired) 737.20 Lordosis (Acquired) 738.2 Hypolordosis of the Cervical/Lumbar Spine (Acquired) 738.2 Reversal of the Cervical Curve 737.30 Scoliosis (Idiopathic) 715.9 Degenerative Joint Disease (Osteoarthritis) 715.95 Degenerative Joint Disease of the Hip 715.96 Degenerative Joint Disease of the Knee 715.09 Osteoarthrosis of Multiple Sites 716.9 Chronic Arthritis 734 Pes Planus, Acquired 754.61 Pes Planus, Congenital 736.41 Genu Valgus 733.0 Osteoporosis 733.01 Osteoporosis Senile 733.02 Osteoporosis Idiopathic

SYMPTOMS:

723.1 Cervicalgia 724.1 Thoracic Spine Pain 724.2 Lumbalgia 648.70 Pregnancy Backache 724.5 Vertebrogenic Pain Syndrome 726.90 Tendinitis/Capsulitis 727.00 Synovitis/Tenosynovitis 727.3 Bursitis 729.1 Myofascitis of Upper or Extremity Musculature 729.4 Fascitis 782.8 Changes In Skin Texture/Induration 728.87 Muscle Weakness 728.85 Muscle Spasm 780.4 Dizziness 438.85 Vertigo 780.4 Dizziness And Giddiness/Light-headedness/Vertigo 780.5 Sleep Disturbance 780.7 Fatigue 787.2 Dysphagia 784.5 Dysarthria/Dysphasia/Slurred speech 784.9 Choking Sensation 784.49 Hoarseness of Speech/Dysphonia/Hypernasality/Hyponasality 787.0 Nausea 782.0 Paresthesia/Tingling/Burning/Prickling 354.8 Nerve Inflammation/Compression (Upper Limb) 443.0 Raynaud's Syndrome 354.4 Causalgia of Upper Limb 355.71 Causalgia of Lower Limb 355.9 Causalgia of (WHATEVER) 780.2 Syncope 726.0 Adhesive Capsulitis of Shoulder 726.11 Calcific Tendinitis of Shoulder 726.12 Bicipital Tenosynovitis 905.6 Late Effects of Subluxation [Late effect of injury classifiable to 830-839] 905.7 Late Effects of Sprain or Strain

Joint Specific Symptoms:

719.01 Edema of Acromioclavicular/Glenohumeral/Sternoclavicular 719.02 Edema of Elbow joint/Humerus 719.03 Edema of Wrist 719.06 Edema of Knee joint/Fibula/Patella/Tibia 719.07 Edema of Ankle/Foot Joints 719.08 Edema of Cervical Spine/Thoracic Spine/Lumbar Spine 719.41 Arthralgia of Shoulder 719.42 Arthralgia of Elbow 719.44 Arthralgia of Hand/Wrist 719.45 Arthralgia of Sacroiliac Joint 719.46 Arthralgia of Knee 719.47 Arthralgia of Ankle/Foot 719.48 Arthralgia of Cervical Spine/Thoracic Spine/Lumbar Spine 719.51 Stiffness of Shoulder 719.52 Stiffness of Elbow 719.53 Stiffness of Hand/Wrist 719.55 Stiffness of Sacroiliac Joint 719.56 Stiffness of Knee Joint 719.57 Stiffness of Ankle/Foot 719.58 Stiffness of Cervical Spine/Thoracic Spine/Lumbar Spine 719.61 Crepitus of Shoulder 719.62 Crepitus of Elbow 719.64 Crepitus of Hand/Wrist 719.65 Crepitus of Sacroiliac Joint 719.66 Crepitus of Knee 719.67 Crepitus of Ankle/Foot 719.68 Crepitus of Cervical Spine/Thoracic Spine/Lumbar Spine

Headaches:

NOTE: Always use the more specific 5 digit code! Cluster Headaches And Other Trigeminal Autonomic Cephalgias 339.00 Cluster headache syndrome, unspecified 339.01 Episodic cluster headache 339.05 Short-lasting unilateral neuralgiform headache with conjunctival injection and tearing 339.09 Other trigeminal autonomic cephalgias Tension Type Headache 339.10 Tension-type headache, unspecified 339.11 Episodic tension-type headache 339.12 Chronic tension-type headache 307.81 Tension Headache Post-traumatic Headache 339.20 Posttraumatic headache, unspecified 339.21 Acute posttraumatic headache 339.22 Chronic posttraumatic headache 339.30 Drug-induced headache, not elsewhere classified Complicated Headache Syndromes 339.41 Hemicrania continua 339.42 New daily persistent headache 339.43 Primary thunderclap headache 339.44 Other complicated headache syndrome Other Specified Headache Syndromes 339.81 Hypnic headache 339.82 Headache associated with sexual activity 339.83 Primary cough headache 339.84 Primary exertional headache 339.85 Primary stabbing headache 339.89 Other specified headache syndromes 784.0 Headache (Facial pain; Pain in head NOS)

Migraines:

Migraine with aura (Classical Migraine) 346.00 Migraine with aura without mention of intractable Migraine without mention of status Migrainosus 346.01 Migraine with aura with intractable Migraine, so stated, without mention of status migrainosus 346.02 Migraine with aura without mention of intractable migraine with status migrainosus 346.03 Migraine with aura with intractable migraine, so stated, with status migrainosus Migraine without aura 346.10 Migraine without aura without mention of intractable Migraine without mention of status Migrainosus 346.11 Migraine without aura with intractable Migraine, so stated, without mention of status migrainosus 346.12 Migraine without aura without mention of intractable migraine with status migrainosus 346.13 Migraine without aura with intractable migraine, so stated, with status migrainosus Variants Of Migraine, not elsewhere classified 346.20 Variants Of Migraine, not elsewhere classified without mention of intractable Migraine without mention of status Migrainosus 346.21 Variants Of Migraine, not elsewhere classified with intractable Migraine, so stated, without mention of status migrainosus 346.22 Variants Of Migraine, not elsewhere classified without mention of intractable migraine with status migrainosus 346.23 Variants Of Migraine, not elsewhere classified with intractable migraine, so stated, with status migrainosus 346.3 Hemiplegic Migraine Please refer to FlashCode Menstrual Migraine 346.40 Menstrual Migraine without mention of intractable Migraine without mention of status Migrainosus 346.41 Menstrual Migraine with intractable Migraine, so stated, without mention of status migrainosus 346.42 Menstrual Migraine without mention of intractable migraine with status migrainosus 346.43 Menstrual Migraine with intractable migraine, so stated, with status migrainosus 346.5 Persistent Migraine Aura Without Cerebral Infarction Please refer to FlashCode 346.6 Persistent Migraine Aura With Cerebral Infarction Please refer to FlashCode Chronic Migraine Without Aura 346.70 Chronic Migraine Without Aura without mention of intractable Migraine without mention of status Migrainosus 346.71 Chronic Migraine Without Aura with intractable Migraine, so stated, without mention of status migrainosus 346.72 Chronic Migraine Without Aura without mention of intractable migraine with status migrainosus 346.73 Chronic Migraine Without Aura with intractable migraine, so stated, with status migrainosus 346.8 Other forms of migraine Please refer to FlashCode 346.9 Migraine, unspecified Please refer to FlashCode

EXTERNAL CAUSES OF INJURY: (The "E" Codes):

Motor Vehicle Traffic Accident Involving Collision With Other Vehicle E812.0 Motor Vehicle Collision w/ Another Vehicle (Injuring Driver) E812.1 Motor Vehicle Collision w/ Another Vehicle (Injuring Passenger) E812.7 Motor Vehicle Collision w/ Another Vehicle (Injuring Pedestrian) Please review the other vehicle accident codes at FlashCode Accidental Fall On or From Stairs or Steps E880.0 Accidental Fall On Or From Escalator E880.1 Accidental Fall On Or From Sidewalk Curb E880.9 Accidental Fall On Or From Other Stairs Or Steps Fall On Same Level From Slipping, Tripping, Or Stumbling E885.9 Fall From Other Slipping, Tripping, Or Stumbling Fall On Same Level From Collision, Pushing, Or Shoving, By or With Other Person E886.0 Fall On Same Level From Collision, Pushing, or Shoving, In Sports E886.9 Fall from collision of pedestrian with another pedestrian (conveyance) Other And Unspecified Accidental Fall E888.0 Fall Resulting In Striking Against Sharp Object E888.1 Fall Resulting In Striking Against Other Object E888.8 Other Fall E916 Struck Accidently by Falling Object Please review other falling object codes at FlashCode Striking Against Or Struck Accidentally By Objects Or Persons E917.0 Striking Against Or Struck Accidentally By Objects or Persons In Sports E917.7 Striking Against Or Struck Accidentally by Furniture with Subsequent Fall E917.8 Striking Against Or Struck Accidentally (Fall in Bathtub) Overexertion And Strenuous And Repetitive Movements Or Loads E927.0 Overexertion From Sudden Strenuous Movement. Sudden trauma from strenuous movement E927.1 Overexertion From Prolonged Static Position E927.2 Excessive Physical Exertion From Prolonged Activity E927.3 Cumulative Trauma From Repetitive Motion Late Effects Of Accidental Injury E929.0 Late Effects Of Motor Vehicle Accident E929.3 Late Effects Of Accidental Fall





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