ICD Multiple Contractures

[Susan Winokur]

When the medical record only states "multiple contractures" does this point to contractures of joint, or muscle? What is the difference between joint contractures and muscle contractures?
Thank you

 

[Melissa Caswell]

This diagnostic statement would need more information in order to code. The provider must document the type of contracture. The type and location should be documented in order to code to the highest specificity. A contracture is defined as an abnormal, often permanent shortening, as of muscle or scar tissue, that results in distortion or deformity, especially of a joint of the body.

 

[Susan Winokur]

What differentiates a contracture of the muscle from a contracture of a joint?

 

[Melissa Caswell]

A contracture of muscle includes the tendon (sheath), so shortening of the muscle. To code a code from the M62.4 Contracture of Muscle Category, the documentation must state the contracture is not of a joint. For example, if the physician documents contracture of the right biceps brachii we would code M62.421 Contracture of muscle, right upper arm, because the biceps brachii is an upper arm muscle and there is no mention of joint involvement. If there is Contracture of muscle and joint documented, use the M24.5 Category, Contracture of Joint, per the Excludes 1 note. Picking the right code all depends on the documentation. When coding multiple sites with contracture of muscle there is a code, M62.49, Contracture of Muscle, multiple sites. For multiple joint contractures, code each individual site.