Documenting and Coding Osteoarthritis (OA)

Hello and Welcome to our podcast series. My name is Meghann Drella and I am a Senior Solutions Manager here at Outsource Strategies International.

Today, I will be discussing how to document and code osteoarthritis – a chronic degenerative joint condition.

One of the most common, chronic joint conditions, osteoarthritis (OA) causes pain, swelling, stiffness and difficulty moving the joint. Also called degenerative joint disease (wear and tear arthritis), the condition occurs when the protective cartilage at the end of your joint breaks down and causes the bones to rub against each other. Although it can damage any joint, the condition primarily affects the knees, and can also affect the fingers, thumbs, spine and hips. Osteoarthritis symptoms often develop slowly and worsen over time. Staying active and maintaining a healthy body weight can help better manage the occurrence of symptoms. Treatment modalities for this condition include medications and other therapeutic techniques.

According to the Arthritis Foundation, about 31 million people in the United States live with the pain of osteoarthritis – the wear-and-tear form of arthritis. Even though this condition can occur in adults of any age, the condition is most often seen in older adults. In fact, the likelihood of developing OA symptoms increases between the ages of 55 and 64. Possible risk factors include – aging, obesity, previous joint injury, overuse of the joint, weak muscles, and genetics.

Osteoarthritis symptoms often develop slowly and worsen over time. Joint pain is one of the primary symptoms of this degenerative joint disease. However, if the pain lasts for more than two weeks, it is important to consult a pain management specialist. Other related symptoms include – joint stiffness and tenderness, bone spurs, limited range of movement in the joints, grating or crackling sound or sensation in the joints, bony enlargements in the middle and end joints of the finger and weakness of muscles wasting.

Physicians, as part of the initial diagnosis, will perform a physical examination and closely examine the affected joints. They will check for tenderness, redness or swelling in the joints. In addition, several diagnostic images tests like X-Rays, MRI scans and lab tests such as blood tests or joint fluid analysis will be performed to confirm the diagnosis. Treatment options involve a combined effort from the part of physical therapists, chiropractors, orthopedic physicians and rehabilitation specialists to assess patients and treat pain symptoms. Various non-invasive treatment modalities like – physical therapy, non-steroidal anti-inflammatory, chiropractic care and joint injections can help patients manage pain and treat joint stiffness and inflammation.

Pain management physicians while diagnosing and treating this degenerative joint condition, must carefully document all the specific procedures using the right medical codes.

Degradation of joint cartilage is part of the natural aging process. While treatment modalities can help relieve OA symptoms to some extent, they cannot fully stop or slow down the degeneration. However, it is possible to minimize the potential risks of developing OA with certain lifestyle changes. These include avoiding overuse of joints, keeping obesity at bay, and maintaining good posture. Adequate physical activity combined with the right medications can help strengthen muscles around the joints and make them more stable, thereby reducing pain.

I hope this helps but always remember that the documentation requires the thorough knowledge of the payer regulations and guidelines is critical to ensure accurate reimbursement for the procedures performed.

Thank you for joining me and stay tuned for my next podcast.