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ICD-10 Coding for Diffuse Idiopathic Skeletal Hyperostosis(M48.1, M48.11)

Complete ICD-10-CM coding and documentation guide for Diffuse Idiopathic Skeletal Hyperostosis. Includes clinical validation requirements, documentation requirements, and coding pitfalls.

Also known as:

DISHForestier's DiseaseAnkylosing Hyperostosis

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Related ICD-10 Code Ranges

Complete code families applicable to Diffuse Idiopathic Skeletal Hyperostosis

M48.1Primary Range

Ankylosing hyperostosis [Forestier]

This range covers the primary codes for diffuse idiopathic skeletal hyperostosis, specifying the location of the condition.

Code Comparison: When to Use Each Code

Compare key differences between these codes to ensure accurate selection

CodeDescriptionWhen to UseKey Documentation
M48.1Ankylosing hyperostosis [Forestier]Use when DISH is the primary reason for the encounter and meets Resnick's criteria.
  • Radiographic confirmation of flowing calcification over four contiguous vertebrae
  • Preserved disc height
  • Absence of sacroiliac joint erosions
M48.11Ankylosing hyperostosis, occipito-atlanto-axial regionUse when DISH affects the occipito-atlanto-axial region.
  • Flowing calcification in the occipito-atlanto-axial region

Clinical Decision Support

Always review the patient's clinical documentation thoroughly. When in doubt, choose the more specific code and ensure documentation supports it.

Key Information: ICD-10 code for diffuse idiopathic skeletal hyperostosis

Essential facts and insights about Diffuse Idiopathic Skeletal Hyperostosis

The ICD-10 code for diffuse idiopathic skeletal hyperostosis is M48.1, with specific subcodes for different spinal regions.

Primary ICD-10-CM Codes for diffuse idiopathic skeletal hyperostosis

M48.1
Ankylosing hyperostosis [Forestier]
Non-billable Code

Decision Criteria

clinical Criteria

  • Radiographic evidence of flowing calcification over four contiguous vertebrae

documentation Criteria

  • Absence of sacroiliac joint erosions

Applicable To

  • Diffuse idiopathic skeletal hyperostosis

Excludes

  • Ankylosing spondylitis (M45)

Clinical Validation Requirements

  • Radiographic confirmation of flowing calcification over four contiguous vertebrae
  • Preserved disc height
  • Absence of sacroiliac joint erosions

Code-Specific Risks

  • Misclassification with ankylosing spondylitis
  • Lack of specificity in location

Coding Notes

  • Ensure documentation specifies the spinal region affected to select the appropriate subcode.
View Full Code Details

Ancillary Codes

Additional codes that should be used in conjunction with the main diagnosis codes when applicable.

Dysphagia

R13.1
Use when dysphagia is present due to cervical osteophytes.

Differential Codes

Alternative codes to consider when ruling out similar conditions to the primary diagnosis.

Ankylosing spondylitis

M45
Presence of HLA-B27 and sacroiliac joint involvement differentiates ankylosing spondylitis from DISH.

Documentation & Coding Risks

Avoid these common documentation and coding issues when documenting Diffuse Idiopathic Skeletal Hyperostosis to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code M48.1.

Impact

Clinical: May lead to misdiagnosis or inappropriate treatment., Regulatory: Potential for audit issues., Financial: Claims may be denied due to lack of specificity.

Mitigation Strategy

Ensure detailed imaging reports are included., Specify the number of vertebrae involved.

Impact

Reimbursement: Incorrect coding can lead to denied claims., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data representation.

Mitigation Strategy

Query for clarification on the specific spinal region involved.

Impact

Lack of specific documentation for the spinal region affected by DISH.

Mitigation Strategy

Implement templates that require detailed imaging findings.

Documentation errors, coding pitfalls, and audit risks are interconnected aspects of medical coding and billing. Addressing all three areas helps ensure accurate coding, optimal reimbursement, and regulatory compliance.

Frequently Asked Questions

Common questions about ICD-10 coding for Diffuse Idiopathic Skeletal Hyperostosis, with expert answers to help guide accurate code selection and documentation.

Documentation Templates for Diffuse Idiopathic Skeletal Hyperostosis

Use these documentation templates to ensure complete and accurate documentation for Diffuse Idiopathic Skeletal Hyperostosis. These templates include all required elements for proper coding and billing.

DISH with dysphagia

Specialty: Orthopedics

Required Elements

  • Radiographic findings
  • Symptoms and their impact
  • Associated conditions

Example Documentation

Patient presents with cervical stiffness and dysphagia. Imaging shows flowing calcification from C3-C7. No sacroiliac joint involvement.

Examples: Poor vs. Good Documentation

Poor Documentation Example
Patient has back pain and stiffness.
Good Documentation Example
Patient reports thoracic stiffness for over 2 years. X-ray confirms flowing calcification T6-T10, disc spaces intact. No SI joint erosions. Meets Resnick criteria for DISH.
Explanation
The good example provides specific diagnostic criteria and imaging findings necessary for accurate coding.

Need help with ICD-10 coding for Diffuse Idiopathic Skeletal Hyperostosis? Ask your questions below.

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