ICD Code M16.9

ICD code M16.9 is osteoarthritis of the hip, unspecified, meaning degeneration of the hip joint without further detail about which side or specific type.

1. Patient presents with chronic hip pain and stiffness.

2. Physical examination reveals reduced range of motion in the hip joint.

3. Imaging studies (e.g., X-ray, MRI) show degenerative changes in the hip joint, such as joint space narrowing, osteophyte formation, or subchondral sclerosis.

4. Symptoms are not attributable to acute trauma, infection, or inflammatory arthropathy.

5. No specific cause or subtype of osteoarthritis (e.g., primary or secondary) is identified.

6. Laterality (right, left, bilateral) is not specified in the clinical documentation.

Relevant CPT codes that may be used to treat ICD code M16.9 include:

- 20610: Arthrocentesis, aspiration and/or injection; major joint or bursa (e.g., hip)

- 27096: Injection procedure for sacroiliac joint, anesthetic/steroid

- 27130: Total hip arthroplasty (total hip replacement)

- 27132: Conversion of previous hip surgery to total hip arthroplasty

- 27134: Revision of total hip arthroplasty; both acetabular and femoral components

- 27137: Revision of total hip arthroplasty; acetabular component only

- 27138: Revision of total hip arthroplasty; femoral component only

- 73502: Radiologic examination, hip, unilateral, with pelvis when performed; 2-3 views

- 73503: Radiologic examination, hip, unilateral, with pelvis when performed; minimum of 4 views

- 73521: Radiologic examination, hips, bilateral, minimum of 2 views of each hip, including pelvis

CPT code selection should be based on the specific treatment or procedure performed for M16.9.

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