Rheumatology Coding Corner Answer: Proper Coding for Post-Traumatic Osteoarthritis

CPT: 99213, 73500-RT, 73500-LT
ICD-10: M16.52

This E/M service entailed:

• The history is detailed;
• The examination is expanded problem focused; and
• The medical decision making is of low complexity.

The X-ray reviewed was for radiologic examination, hip, unilateral: one view for the left hip and for the right hip.

M16.52—The diagnosis identifies unilateral post-traumatic osteoarthritis of the left hip.

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