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

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

This section is 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.   (Very Useful FREE tool!)


Other
Pages:
    Outcome Assessment          Safety of Chiropractic              Forward Head

                 Patient Satisfaction             Cost-Effectiveness                     Disc Herniation

                 Chronic Neck Pain               Subluxation Complex              Headache Page

                 Guidelines Section              Whiplash Section                      Low Back Pain

                 Stroke & Chiropractic         Problems With Placebos         Iatrogenic Injury

                 Conditions That Respond Well                Alternative Medicine Approaches
 
   

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!!!

"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 tissue to 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.

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 pathologies 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:

The Cervical Spine:

The MEDICARE listings for Subluxation (the 739 series):
739.0   Occipital Subluxation
739.1   Cervical Subluxation
739.2   Thoracic  Subluxation
739.3   Lumbar Subluxation
739.4   Sacrum or Coccyx Subluxation
739.5   Pelvic (Ilia or SI) Subluxation


Personally, I prefer the 839 series:
839.01   Subluxation of First Cervical Vertebra
839.02   Subluxation of First Second Vertebra (.03 = Third, etc. 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)
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

PLEASE 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
719.08   Edema of Thoracic Facet Joint
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
719.08   Edema of Lumbar Facet Joint
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
805.2    Compression Fracture
805.4    Compression Fracture Lumbar

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 Extremity Musculature
729.1    Myofascitis of Lower Extremity Musculature
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

346.00   Classical Migraine
346.01   Classical Migraine, Intractable
346.10   Commmon Migraine Headache
346.11   Common Migraine, Intractable
346.20   Allergic or Cluster Migraine Headache
346.21   Allergic or Cluster Migraine Headache, Intractable
346.90   Vasomotor Headache
346.90   Vasomotor Headache, Intractable

784.0    Common Headache
307.81   Tension Headache


Peripheral Joint 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

719.41   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


EXTERNAL CAUSES OF INJURY ("E" CODES):

FOR 810-819 CODES, USE THESE MODIFIERS: .0 = DRIVER OF MVA OTHER THAN MOTORCYCLE .1 = PASSENGER " " " " .2 = MOTORCYCLIST .3 = PASSENGER ON MOTORCYCLE .7 = PEDESTRIAN
E812.0   Motor Vehicle Collision w/ Another Vehicle (Driver)
E812.1   Motor Vehicle Collision w/ Another Vehicle (Passenger)
E816.1   Motor Vehicle Traffic Accident Due to Loss of Control, Without Collision on the Highway
E823.0   Motor Vehicle Collision w/ Stationary Object (Driver)
E823.1   Motor Vehicle Collision w/ Stationary Object (Passenger)
E880.0   Accidental Fall on Stairs (@ Home)
E880.3   Accidental Fall on Stairs (@ Industrial Place)
E880.4   Accidental Fall on Stairs (@ Place for Recreation)
E880.6   Accidental Fall on Stairs (@ Public Building)
E885.0   Accidental Fall on Same Level (Slip, Trip, Stumble) (@ Home) 
         NOTE: Use the endings for 880 series for other locations
E886     Accidental Fall on Same Level (Collision, Push, Shove)
         NOTE: Use the endings for 880 series for other locations
E886.0   Accidental Fall in Sports
E916     Struck Accidently by Falling Object
E917     Struck by Object or Person
E917.0   Struck by Object in Sports
E927     Overexertion and Strenuous Movements
E929.0   Late Effects of Motor Vehicle Accident
E929.3   Late Effects of Accidental Fall
Partners in Research!

Return to the LINKS Table of Contents

Return to the CHIROPRACTIC TOOLS Section

Return to the CLINICAL IMPRESSION Section


Since 5-01-97

Updated 3-10-2008

         © 2008   The Chiropractic Resource Organization   All Rights Reserved