UCSD Musculoskeletal Radiology bonepit.com Pathology Index

.1 NORMAL ROUTINE PLAIN FILM

                    exclude. normal variant (.13)

.12 SPECIAL TECHNIQUE, PROCEDURE, PROJECTION

.121 Digital radiographic techniques, tomography, MR, nuclear medicine

.1211 Computed tomography

.12111 Unenhanced

.12112 Enhanced with intravenous drip or bolus

.12113 Dynamic enhanced technique

.12114 Delayed scanning following enhancement (e.g., for detection of liver lesions)

.12115 Spiral scanning

.12116 CT angiography

.12117 Three-dimensional reconstruction

.12118 High-resolution technique

.12119 Other, including serial enhancement studies (e.g., for diagnosis of hemangioma)

.1214 Magnetic resonance (MR)

.12141 Morphologic magnetic resonance imaging

.121411 Spin echo

.121412 Gradient echo

.121413 Inversion recovery

.121414 Chemical shift imaging

.121415 Specific resonance suppressed

.121416 High-speed imaging

.121417 Magnetization transfer

.121419 Other

.12142 MR angiography (morphological vascular imaging)

.12143 Contrast-enhanced studies, trace studies

.12144 MR velocity measurements, flow volumetry studies, motion studies, diffusion studies

.12145 MR spectroscopy, spectroscopic imaging

.12146 Quantitative tissue characterization, relaxometry

.12147 Imaging of nuclei other than hydrogen

.12149 Other

.1215 Digital radiography

.1216 Nuclear medicine study

.12161 Planar scintigraphy

.12162 SPECT

.12163 PET

.12164 Blood pool imaging

.12165 Inflammation-avid radiopharmaceutical imaging

.12166 Tumor-avid radiopharmaceutical imaging

.12167 Thrombus-avid radiopharmaceutical imaging

.12168 Therapeutic procedure

                    include: use of monoclonal antibodies

.12169 Other. See also 1.12178 Receptor-avid radiopharmaceutical imaging

.1217 Nuclear medicine study-musculoskeletal

.12171 Bone mineral measurement

.12172 Bone scintigraphy

.12173 Metabolism study

.12174 Bone marrow scintigraphy

.12179 Other

.1218 Conventional tomography

.1219 Other

.122 Arthrography (see .48)

.123 Mensuration technique

                    include: leg length study, cortical thickness

.124 Angiography (see also 9.)

.1243 Digital angiography

.125 Special nonroutine projection

.126 Biopsy or interventional

.1261 Biopsy

.1262 Aspiration

.1263 Catheter drainage

.1264 Embolization

.1265 Thrombolytic infusion

.1266 Chemotherapeutic infusion

.1267 Operative procedure

                    include: stereotaxis

.1269 Other

.127 Bone age determination (see .55)

.128 Foreign body localization

.129 Miscellaneous

.1291 Therapy localization (port film)

.1292 Magnification technique

.1293 Soft tissue technique

.1294 Supra voltage roentgenography

.1295 Bone mineral analysis

                    exclude: analysis using radionuclides (.12171)

.1296 Cine, video study

.1298 Ultrasonography

.12981 Real time

.12982 A-mode

.12983 B-scan

.12984 Doppler

.12985 Guided procedure for diagnosis

                    include: biopsy

.12986 Guided procedure for therapy

                     include: drainage

.12987 Computerized reconstruction

.12988 Contrast material added

.12989 Special nonroutine projection mode, or transducer type

.1299 Other

                    include: xeroradiography, thermography

.13 NORMAL VARIANT

.131 Accessory center of ossification, unusual sesamoid, accessory ossicle

                    include: bipartite patella

.132 Developmental spur (e.g., supracondylar process)

.133 Density variant

.1331 Physiological osteosclerosis of the newborn

.1332 Transverse (growth) line

.1333 Ivory epiphysis

.1334 Bone island

.1339 Other

.134 Irregular ossification

                    include: Meyer dysplasia

.135 Physiological bowing

                    exclude: Blount disease (.1481)

.136 Prematurity

.137 Vacuum joint, gas in symphysis in pregnancy

.138 Periosteal reaction of infancy

.139 Other

                    include: double cortical line, rhomboid fossa, skin fold, vascular groove or foramen, uncommon order of onset of ossification (e.g., of carpal bones)

                    exclude: absent rib (.141), accessory rib (.1442), Baker cyst (.783), calcified articular cartilage (.814), fibrous cortical defect (.3l31), phlebolith (.812)

.14 CONGENITAL ANOMALY, DEVELOPMENTAL ABNORMALITY

.141 Aplasia, agenesis

                    include: absent rib, amelia, hemimelia, phocomelia, absent pectoral muscle

                    exclude: Poland syndrome (.1621), amniotic band (.1498)

.142 Hypoplasia

                    include: hemiatrophy, brachydactyly

                    exclude: associated with hematologic disorder (.653), Poland syndrome (.1621), amniotic band (.1498)

.143 Fusion, failure of segmentation include: syndactyly, symphalangism, synostosis

                    exclude: polysyndactyly (.1441)

.144 Hypersegmentation, hyperplasia

.1441 Polydactyly, polysyndactyly

.1442 Other supernumerary bone

                    include: accessory rib, Os centrale

.1443 Hemihypertrophy

.1444 Localized "gigantism" associated congenital hemangioma, lymphangioma, arteriovenous fistula, neurofibroma

.1449 Other

                    include: congenital lymphedema

                    exclude: cerebral gigantism (.1712 pituitary gigantism (.511)

.145 Congenital bowing

                    exclude: camptomelic syndrome (.1624), physiological bowing (.135)

.146 Congenital dislocation

                    exclude: multiple congenital dislocations (Larsen syndrome) (.1626)

.147 Foot deformity

.l471 Pes cavus

                    exclude: paralytic (.829)

.1472 Flat foot-rigid (spastic)

                    include: vertical talus, intertarsal bar

.1473 Flat foot-nonrigid (flexible)

.1474 Metatarsus varus adductus

.1475 Clubfoot (talipes equinovarus)

.1476 Rocker-bottom foot

.1477 Calcaneovarus, calcaneovalgus

.1479 Other

                    exclude: arthrogryposis (.1893), paralytic deformity (.829)

.148 Developmental deformity

.1481 Varus deformity

                    include: Blount disease

                    exclude: metatarsus varus adductus (.1474), physiological bowing (.135)

.1482 Valgus deformity

.1483 Anteversion

.1484 Unequal leg lengths (also code cause)

.1485 Ectopia

                    include: Sprengel deformity

.1486 Clinodactyly

.1487 Camptodactyly

.1489 Other

                    include: hammer toe, tibial torsion Kirner deformity

                    exclude: genu recurvatum (.l493), paralytic deformity (.829), pes cavus (.l471), flat foot (.1472, .1473)

.149 Miscellaneous

.1491 Madelung deformity, congenital or acquired

                    exclude: dyschondrosteosis (.1537)

.1492 Congenital pseudarthrosis

.1493 Genu recurvatum

.1494 Congenital arteriovenous fistula

                    exclude: post-traumatic (.494)

.1495 Discoid meniscus

.1496 Pectus excavatum

.1497 Pectus carinatum

.1498 Effect of amniotic band

.1499 Other

                    include: pterygium syndrome

                    exclude: abnormal fetus, monster (8.826), dysplasia (.15), dysostosis (.16); soft tissue edema (hydrops) (.833)

.15 DYSPLASIA

.151 Osteochondrodysplasia-often lethal in neonate

.1511 Achondrogenesis

                    exclude: Grebe syndrome (.1629)

.1512 Asphyxiating thoracic dysplasia (Jeune)

.1513 Thanatophoric dwarfism

.1514 Short rib polydactyly

.1519 Other

                    include: ateleosteogenesis, dyssegmental dwarfism

                    exclude: chondrodysplasia punctata (.1522), hypochondrogenesis (.1528)

.152 Osteochondrodysplasia-manifest in neonate

.1521 Achondroplasia

.1522 Chondrodysplasia punctata (stippled epiphyses)

                    include: Zellweger (cerebrohepato-renal) syndrome

.1523 Chondroectodermal dysplasia (Ellis van Creveld) (see 5.1962 for cardiac lesion)

.1524 Cleidocranial dysplasia (dysostosis)

.1525 Diastrophic dwarfism

.1526 Metatrophic dwarfism, Kneist syndrome

.1527 Spondyloepiphyseal dysplasia congenita, Strudwick syndrome

.1528 Spondyloepiphyseal dysplasia present at birth, other

                    include: hypochondrogenesis

.1529 Other

                    include: mesomelic dwarfism (Nievergelt, Langer, Robinow), acromesomelic dwarfism, Dyggve Meichior Clausen syndrome

.153 Osteochondrodysplasia-manifest in later life

.1530 Hypochondroplasia

.1531 Pseudoachondroplastic dysplasia

.1532 Spondyloepiphyseal dysplasia tarda

.1533 Spondyloepiphyseal dysplasia, other

.1534 Spondylometaphyseal dysplasia

                    include: Kozlowski type

.1535 Multiple epiphyseal dysplasia

.1536 Metaphyseal chondrodysplasia (dysostosis)

                    include: Jansen, McKusick, or Schmid type, type with malabsorption and neutropenia, type with thymolymphopenia

.1537 Dyschondrosteosis

.1538 Acrodysplasia (types I and II)

                    include: trichorhinophalangeal syndrome (types I and II), epiphyseal (Thiemann), epiphysiometaphyseal (peripheral dysostosis)

                    exclude: acromesomelic dwarfism (.1529)

.1539 Other

                    include: hereditary arthroophthalmopathy (Stickler), parastremmatic dwarfism, cranioectodermal dysplasia

.154 Dysplasia of cartilage, dysplasia of fibrous components

.1541 Dysplasia epiphysealis hemimelica

.1542 Multiple cartilaginous exostoses

1543 Enchondromatosis (Ollier)

                    include: with hemangiomata (Maffucci)

.1544 Infantile (juvenile) fibromatosis

.1549 Other

                        include: metachondromatosis

                        exclude: cherubism (2.1545), fibrous dysplasia (.85)

.155 Dysplasia with abnormal cortical formation, modeling, density

1551 Osteogenesis imperfecta

.1552 Osteopetrosis

.1553 Pyknodysostosis

.1554 Osteopoikilosis, melorrheostosis, osteopathia striata

.1555 Diaphyseal dysplasia

                    include: Engelmann disease, craniodiaphyseal dysplasia, hyperphosphatasemia, Van Buchem disease

.1556 Metaphyseal dysplasia

                    include: Pyle disease, craniometaphyseal dysplasia, frontometaphyseal dysplasia

.1557 Oculodento-osseous dysplasia (oculodentodigital syndrome)

.1559 Other

                    include: medullary stenosis, osteodysplasty (Melnick Needle syndrome), pachydermoperiostosis, autosomal dominant osteosclerosis, osteomesopycnosis

                    exclude: juvenile idiopathic osteoporosis (.563)

.159 Other dysplasia

.16 DYSOSTOSIS

.161 Soft tissue dysostosis

.1611 Fibrodysplasia (myositis) ossificans progressiva

.1612 Popliteal pterygium syndrome

.1619 Other

.162 Limb dysostosis

.1621 Poland syndrome (pectoral dysplasia dysdactyly)

.1622 Rubenstein-Taybi syndrome

.1623 Nail-patella syndrome

.1624 Camptomelic syndrome, familial congenital bowing

.1625 Len syndrome (pleonosteosis)

.1626 Multiple congenital dislocations (Larsen syndrome)

.1629 Other

                    include: whistling-face syndrome, Grebe syndrome

                    exclude: aplasia, agenesis (.141), hypoplasia (.142), fusion (.143), hypersegmentation (.144), hyperplasia (.144)

.163 Limb-facial dysostosis

.1631 Orofacial digital syndrome

.1632 Hypoglossia-hypodactylia syndrome

.1633 Oto-palato-digital syndrome

.1639 Other

                    include: Robert pseudo-thalidomide syndrome

                    exclude: oculodento-osseous dysplasia (.1557), craniosynostosis 1.143), facial dysostosis (2.16)

.164 Limb-visceral dysostosis

.1641 Cardiomelic syndrome

                    include: Holt-Oram (see 5.l961 for cardiac lesion)

.1642 Noonan syndrome (see 5.1964 for cardiac lesion)

.1643 Hand-foot-uterus syndrome

.1649 Other

.165 Spinal dysostosis (see 3.165 for detailed classification)

.1651 Spondylocostal dysostosis

.166 Facial dysostosis (see 2.166 for classification)

.167 Dysostosis involving multiple systems

.1671 Basal cell nevus syndrome

.1679 Other

.169 Other dysostosis

                    exclude: facial 'dysostosis (2.16), craniosynostosis 1.143), cranial dysostosis (1.16), dysostosis with hematological

disorder (4.653), Goldenhar syndrome (.1662)

.17 PRIMARY DISTURBANCE OF GROWTH

.171 Increased growth

.1711 Marfan syndrome (see 5.l971 for cardiac lesion)

.1712 Cerebral gigantism

                    exclude: pituitary gigantism (.511)

.1719 Other

                    include: Beckwith-Wiedemann syndrome, contractural arachnodactyly

                    exclude: homocystinuria (.597)

.172 Decreased growth

.1721 Progeria

                    include: neonatal progeroid syndrome

.1722 Weill-Marchesani syndrome

.1723 Cornelia de Lange syndrome

.1724 Russell-Silver dwarfism

.1725 Primordial dwarfism

.1726 Menkes (kinky hair) syndrome

.1727 Intrauterine growth retardation (dwarfism), nonspecific

.1728 Fetal alcohol syndrome,  fetal Dilantin syndrome

.1729 Other

                    include: bird-headed dwarfism, leprechaunism, Cockayne syndrome, Bloom syndrome, geroderma osteodysplastica, Coffin-Lowery syndrome, Smith-Lemli.-Opitz syndrome

                    exclude: dysplasia (.15), dysostosis (.16)

.18 OTHER CONSTITUTIONAL DISORDER

.181 Mucopolysaccharidosis (MPS)

.1811 Hurler syndrome (MPS I-H)

.1812 Hunter syndrome (MPS II)

.1813 Sanfilippo syndrome (MPS III)

.1814 Morquio syndrome (MPS IV)

.1815 Maroteaux-Lamy syndrome (MPS VI)

.1819 Other

                    include: Scheie (MPS I-S), Hurler Scheie compound (MPS I-H/S), beta glucuronidase deficiency (MPS VII)

.182 Dysostosis multiplex, other cause

.1821 Lipomucopolysaccharidosis (ML I)

.1822 I-cell disease (ML II)

.1823 Pseudo-Hurler polydystrophy (ML III)

.1824 GM1 gangliosidosis

.1825 Glycoproteinosis

                    include: aspartylglycosaminuria, fucosidosis, mannosidosis, sialidosis

.1829 Other

                    include: Austin type sulfatidosis, multiple sulfatase deficiency, Sandhoff disease

                    exclude: sphingolipidosis (.67), Farber disease (.679)

.183 Neurocutaneous syndrome (phakomatosis

.1831 Neurofibromatosis (see also .1444)

.1832 Tuberous sclerosis

.1839 Other

                exclude: fibrous dysplasia (.85), infant (juvenile) fibromatosis (.1544), Sturge-Weber (1.1833), Hippel-Lindau (1.1834)

.184 Autosomal aberration

.l841 Trisomy 21 (Down syndrome)

.1842 Trisomy 18

.1843 Trisomy 13

.1849 Other

                    include: cat-cry (cri-du-chat)

.185 Sex chromosomal aberration

.1851 Turner syndrome

.1859 Other

                    exclude: Noonan syndrome (.1642)

.186 Idiopathic osteolysis (see .3143)

.1861 Hajdu-Chaney syndrome

.1862 Other phalangeal acro-osteolysis

.1863 Tarsal-carpal form of acro-osteolysis (multicentric)

.1869 Other

                    include: Winchester syndrome

.189 Miscellaneous

.1891 Ehlers-Danlos syndrome (see 5.1972 for cardiac lesion)

.1892 Lipodystrophy

.1893 Arthrogryposis multiplex congentia (amyotonia congenita)

.1894 Lawrence-Moon-Bardot-Biedel syndrome

.1899 Other

                    exclude: hypophosphatasia (.593), phenylketonuria (.596), sphingolipidosis (.67), idiopathic hypercalcemia of infancy (.599)

.19 OTHER

                    include: syndrome, unclassified

.20 INFECTION CLASSIFIED BY ORGANISM

            (see 6.20 for detailed classification)

.201 Gram-positive facultative bacterium

.2012 Staphylococcus

.2013 Streptococcus

.202 Gram-negative bacterium

.2025 Salmonella

.2029 Neisseria (gonococcus)

.203 Mycobacterium

                    exclude: tuberculosis (.23)

.2031 Anonymous (atypical)

.2032 Mycobacterium leprae (leprosy)

.204 Anaerobic bacterium

.2044 Actinomycosis

.205 Fungus

.2051 North American blastomycosis

.2052 Coccidiodomycosis

.2053 Histoplasmosis

.2054 Cryptococcus (torulosis)

.2055 Nocardiosis

.2056 Aspergillosis

.2057 Candidiasis (moniliasis)

.2059 Other

                        include: mucormycosis, sporotrichosis South American blastomycosis

.206 Virus or mycoplasma

.2063 Measles

.2064 Chickenpox

.2065 Herpes

.2066 Cytomegalovirus (cytomegalic inclusion disease)

.2068 Human immunodeficiency virus infection (AIDS)

.207 Protozoa or spirochete

.2076 Syphilis, congenital

.2077 Syphilis, acquired

.2079 Other

                    include: Lyme disease

.208 Helminth, roundworm, flatworm

.209 Other

                    include: rickettsia

.21 OSTEOMYELITIS

            (for 4th number see box following .219)

.211 Typical manifestation

.212 Unusual manifestation    

                    include: epiphyseal infection

.213 Brodie abscess (cystic osteomyelitis)

.214 Associated with systemic disorder

                    include: sickle cell disease, granulomatous disease of childhood (Landing-Shirkey syndrome; neutrophil dysfunction) (see 7.296)

.215 Unusual organism

                    include: fungus, parasite, virus, spirochete

                    exclude: transplacental infection (.27)

.216 Secondary to trauma

                    include: postoperative

.217 Opportunistic infection

.218 Bone reaction secondary to soft tissue infection

.219 Other

                    include: narcotic abuse, chronic recurrent multifocal osteomyelitis

                    exclude: syphilis (.2076, .2077), leprosy (.2032), transplacental infection (.27)

            4th number for use with .21

                    .___1 Acute

                    .___2 Subacute

                    .___3 Chronic

.22 SARCOIDOSIS

.23 TUBERCULOSIS

.24 SOFT TISSUE INFLAMMATION, SINUS TRACT, FISTULA

.241 Cellulitis

.242 Abscess, gas gangrene

.243 Ulcer (soft tissue)

.244 Sinus tract

.245 Fistula

.246 Lymphadenitis

.247 Maduromycosis (Madura foot)

.249 Other

.251 Bursitis

                    include: calcific

.252 Synovitis

                    exclude: nonspecific (.785), pigmented villonodular (.784), tuberculous (.23)

.253 Tendinitis

                    include: calcified, Pellegrini-Stieda

.254 Joint effusion

                    exclude: traumatic (.492), suppurative arthritis (.26) .

.259 Other

                    exclude: Baker cyst (.783), osteochondromatosis (.782), pigmented villonodular synovitis (.784), specific arthritis (.26, .7)

.26 INFECTIOUS (SUPPURATIVE) ARTHRITIS'

                    exclude: other arthritis (.7), e.g., rheumatoid (.71) Reiter syndrome (.73)

.27 CHANGE SECONDARY TO TRANSPLACENTAL INFECTION

                    include: rubella, cytomegalovirus

.29 OTHER

                    include: osteitis pubic, periosteal reaction associated with vascular insufficiency

                    exclude: condensans ilii (.863), soft tissue swelling of undetermined etiology (.833), leprosy (.2032), syphilis (.2076, .2077)

.298 Infectious complications of AIDS

                    include: bacillary angiomatosis

.3 NEOPLASM, NEOPLASTIC-LIKE LESION

.31 BENIGN NEOPLASM OF BONE

.311 Cartilaginous origin

.3111 Chondroblastoma

.3112 Chondromyxoid fibroma

.3113 Osteochondroma (osteocartilaginous exostosis)

                    exclude: multiple exostoses

.3114 Enchondroma

                    exclude: enchondromatosis (Olliers .1543)

.3115 Juxtacortical (parosteal) chondroma

.3119 Other

.312 Osseous origin

.3121 Osteoma

.3122 Osteoid osteoma

.3123 Osteoblastoma

.3129 Other

                    include: Gardner syndrome (also code 7.3114)

.313 Fibrous origin

.3131 Fibrous cortical defect, nonossifying fibroma

.3132 Desmoplastic fibroma

.3139 Other

                    include: ossifying fibroma

                    exclude: fibrous dysplasia (.85), infantile (juvenile) fibromatosis (.1544), parosteal desmoid (.434), fibrous histiocytoma (.3185)

.314 Vascular, lymphatic origin

.3141 Hemangioma

.3142 Lymphangioma

.3143 Skeletal angiomatosis

                    include: Gorham disease ("vanishing bone") (see also .186)

.3149 Other

                    include: hemangiopericytoma (benign or malignant)

.315 Nerve tissue origin

.318 Unknown origin

.3181 Solitary bone cyst

.3182 Giant cell tumor (benign or malignant)

                    exclude: of tendon sheath (.784)

.3183 Aneurysmal bone cyst

.3184 Adamantinoma

.3185 Fibrous histiocytoma (benign) (see .3285, .376)

.3189 Other

.319 Other

                    include: lipoma, mesenchymal neoplasm, intraosseous ganglion

                    exclude: epidermoid inclusion cyst (.369), pigmented villonodular synovitis (.784), soft tissue neoplasm (.36)

.32 MALIGNANT NEOPLASM OF BONE-PRIMARY

.321 Cartilaginous origin

.3211 Chondrosarcoma

.3212 Mesenchymal chondrosarcoma

.3219 Other

.322 Osseous origin

.3221 Osteosarcoma

.3222 Parosteal osteosarcoma

.3229 Other

.323 Fibrous origin

.3231 Fibrosarcoma .

3239 Other

                    exclude: fibrous histiocytoma (.3285)

.324 Vascular origin

                    include: angiosarcoma, hemangiosarcoma

                    exclude: hemangiopericytoma (.3149), lymphoma (.34), myeloma (.345)

.325 Nerve tissue origin

                    include: neurosarcoma

.328 Unknown origin

.3281 Ewing tumor

.3285 Fibrous histiocytoma (malignant) (see .3185, .376)

.3289 Other

.329 Other

                    include: neoplasm associated with AIDS

            (for 4th number see box following .33)

                    exclude: invasion from adjoining lesion (.37).

            4th number for use with .33 For site of primary tumor add 4th number using anatomical field number of the primary site. Use ---9 for primary site unknown.

.341 Leukemia

.342 Hodgkin disease

.343 Non-Hodgkin lymphoma

.3431 Lymphocytic well differentiated

.3432 Nodular

.3433 Diffuse

.3434 Histiocytic

.3435 Burkitt

.3439 Other

.345 Myeloma

.3451 Plasmacytoma

.3452 Multiple myeloma

.3459 Other

.346 Kaposi sarcoma

.349 Other

                    include: Waldenstrom macroglobulinemia

.35 NEOPLASM ARISING IN PREEXISTING BENIGN DISORDER

.351 Bone neoplasm (e.g., enchondroma, osteochondroma)

.352 Infection

.353 Paget disease

.354 Irradiated bone

.355 Fibrous dysplasia

.356 Bone infarction

.359 Other

.36 BENIGN SOFT TISSUE NEOPLASM (WITH OR WITHOUT BONE INVOLVEMENT)

.361 Ganglion

                    exclude: intraosseous ganglion (.319)

.362 Hemangioma, lymphangioma, cystic hygroma

                    exclude: with localized "gigantism" (.1444)

.363 Lipoma, lipoblastoma

.364 Neurofibroma, neurilemmoma

                    exclude: neurofibromatosis (.1831)

.365 Osteochondromatosis

.366 Teratoma, dermoid (benign or malignant)

.369 Other

                    include: epidermoid inclusion cyst, glomus tumor

                    exclude: Baker cyst (.783), pigmented villonodular synovitis (giant cell tumor of tendon sheath) (.784), infantile (juvenile) fibromatosis (.1544)

.371 Liposarcoma

.372 Fibrosarcoma

.373 Rhabdomyosarcoma

.374 Synovioma

.375 Osteosarcoma, chondrosarcoma

.379 Other

                    exclude: leukemia (.34), lymphoma (.34), myeloma (.34), arising in pre-existing benign disorder (.35)

.39 OTHER

                    include: recurrent neoplasm, metastatic neoplasm in soft tissue

                    exclude: fibrous dysplasia (85)

.41 FRACTURE

            (for 4th number see box following .4199)

.411 Linear or spiral

.412 Impacted

                    include: torus

.413 Comminuted

.414 Epiphyseal

.4141 Salter I

.4142 Salter 2

.4143 Salter 3

.4144 Salter 4

.4145 Salter 5

.4146 Epiphysiolysis

                    include: slipped femoral capital epiphysis

.4149 Other

.415 Stress (march)

.416 Pathological (also code cause)

.417 Healed, old

.418 Multiple

.419 Miscellaneous

.4191 Avulsion, chip

.4192 Cortical, greenstick, subperiosteal

.4193 Traumatic amputation

                    exclude: self-mutilation (.496)

.4194 Traumatic periostitis

.4195 Child abuse (battered child)

                    exclude: sexual abuse (8.419)

.4199 Other

                    include: pseudofracture (also code cause), refracture, fracture of spur or sesamoid, traumatic bowing

                    exclude: complication of fracture (.43), congenital indifference to pain (.821)

            4th number for use with .411 to .418

                    1 Colles

                    2 Smith

                    3 Monteggia

                    4 Galleazzi

                    5 Bennett

                    6 Other

                    include: postdislocation deformity, separation of symphysis (obstetrical)

                    exclude: congenital (.146), epiphyseal (.414), slipped femoral capital epiphyseal (.4146), associated with muscular or nervous system disorder (.82, .83)

.421 Without fracture

.422 With fracture

.431 Malunion

                        include: altered mortise, altered weight bearing line, loss of carrying angle

.432 Nonunion

                    include: delayed union, fibrous union, pseudarthrosis

                    exclude: congenital pseudarthrosis (.1492)

.433 Premature epiphyseal closure

.434 Parosteal (periosteal) desmoid

.435 Epidermoid inclusion cyst of bone

.436 Soft tissue change

                    include: contracture, atrophy

.439 Other

                    include: traumatic bone cyst, increased bone length

                    exclude: ischemic (aseptic) necrosis (.44), fibrodysplasia (myositis) ossificans progressiva (.1641), fibrodysplasia (myositis) ossificans (.811) osteomyelitis (.21), post-traumatic degenerative joint disease (.779)

.441 Bone infarct (also code cause)

.442 Subcortical (osteochondritis dissecans)

.443 Perthes disease

.449 Other

                    include: Osgood-Schlatter disease    

                    exclude: Blount disease (.1481), loose body in joint (.48), epiphysiolysis (.4146), neuropathic skeletal disorder (.821), osteochondromatosis (.782)

.45 POSTOPERATIVE

.451 Fusion, arthrodesis, osteotomy

.452 Amputation

.453 Metallic fixation

.454 Prosthesis

.455 Transplant

.456 Bone graft (donor) site

.458 Complication of surgery or interventional procedure

                    include: of biopsy, of aspiration

                    exclude: of catheterization (9.44), of angiography (9.44)

.459 Other

.461 Opaque

.4641 Catheter or other tube

.4642 Catheter (or other tube) in satisfactory position

.4643 Catheter (or other tube) in unsatisfactory position

.4647 Complication of catheter (or other tube)

4649 Other

.462 Nonopaque

.469 Other

            5th number for use with .46

                    1 With acoustical shadowing (ultrasonography)

                    2 Without acoustical shadowing (ultrasonography)

.47 EFFECT OF RADIATION

                    include: radium poisoning

.48 CARTILAGE, LIGAMENT, MENISCUS, CAPSULAR INJURY

.481 Shoulder

.4811 Anterior capsular dislocation

.4812 Posterior capsular dislocation

.4813 Rotator cuff tear

.4814 Adhesive capsulitis

.4815 Loose body

.4819 Other

.482 Elbow

.483 Wrist

.484 Hip

.4841 Articular cartilage degeneration (see also .77)

.4842 Displaced labrum

.4843 Communicating bursa

.4844 Other loose body

.4849 Other

                    exclude: synovitis (.785)

.485 Knee

.4851 Articular cartilage degeneration

.4852 Meniscal tear

.4853 Peripheral meniscal separation

.4854 Meniscal cyst

.4855 Meniscal degeneration

.4856 postmeniscectomy

.4857 Ligament tear

.4857 Other

                    include: loose body

                    exclude: synovitis (.785), discoid meniscus (.1495)

.486 Ankle

.489 Other

.49 MISCELLANEOUS

.491 Laceration, soft tissue swelling secondary to trauma, wringer injury

.492 Traumatic hemarthrosis or hydrarthrosis

.493 Soft tissue emphysema

.494 Arteriovenous fistula, post-traumatic

                    include: pseudoaneurysm

                    exclude: congenital fistula (.1494)

.495 Fat-fluid level in joint

.496 Self-mutilation (see .599) include: self-amputation

.499 Other

                    include: intravascular gas

                    exclude: calcified hematoma (.811), thermal injury (.822), "vanishing bone" (.3143), Sudeck atrophy (.565)

                    exclude: cerebral gigantism (.1712)

.512 Acromegaly

.513 Pituitary dwarfism

.519 Other

                    include: psychosocial dwarfism (emotional deprivation syndrome)

.52 THYROID DISORDER

.521 Cretinism, hypothyroidism

.522 Hyperthyroidism (see also .523)

.523 Thyroid acropachy

.529 Other

.53 PARATHYROID DISORDER

.531 Primary hyperparathyroidism

.5311 Subperiosteal resorption

.5312 Brown tumor

.5319 Other

                    exclude: congenital (.539)

.532 Secondary hyperparathyroidism, nonrenal

.5321 Subperiosteal resorption

.5322 Osteosclerosis

.5323 Brown tumor

.5329 Other

.533 Hypoparathyroidism

.534 Albright hereditary osteodystrophy (pseudohypoparathyroidism)

.539 Other

                    include: congenital hyperparathyroidism

                    exclude: renal osteodystrophy (.573)

.54 ADRENAL DISORDER

.541 Cushing syndrome, endogenous

.542 Cushing syndrome, exogenous

                    include: steroid therapy

.543 Adrenogenital syndrome

.549 Other

            (also code cause)

.551 Retarded bone age

.552 Advanced bone age

.553 Dysharmonic maturation

.559 Other

.56 OSTEOPOROSIS

.561 Scurvy

.562 Senile, postmenopausal

.563 Idiopathic juvenile

.564 Disuse atrophy

.565 Sudeck atrophy (reflex sympathetic dystrophy syndrome)

                    include: malnutrition, trace element (e.g., copper) deficiency (see .579), transient osteoporosis

                    exclude: Cushing syndrome (.541, .542), hyperthyroidism (.522), Turner syndrome (.1851), paralytic (.82)

.57 OSTEOMALACIA, RENAL OSTEODYSTROPHY

.571 Osteomalacia, rickets-dietary

.572 Osteomalacia, rickets-other

.5721 Gastroenterogenous

                    include: biliary atresia, malabsorption

.5722 Organic renal disease (see also .573)

                    include: chronic pyelonephritis, cystic disease

.5723 Renal tubular dysfunction

                    include: cystinosis, Fanconi syndrome, Albright-Butler syndrome, vitamin D resistant rickets, tyrosinosis

.5724 Vitamin D-dependent rickets

.5729 Other

                    include: Wilson disease, phenytoin (Dilantin) therapy, atypical axial osteomalacia (see .789, 1.592)

.573 Renal osteodystrophy (osteomalacia plus secondary hyperparathyroidism)

.579 Other

                        include: copper deficiency (see .569)

                        exclude: hypophosphatasia (.593), phenylketonuria (.596)

.58 INTOXICATION, POISONING

.581 Heavy metal

.5811 Lead

.5819 Other

.582 Fluorine

.5831 Vitamin A

.5832 Vitamin D

.5839 Other

.589 Other

.59 MISCELLANEOUS

.591 Growth acceleration, secondary

                    exclude: conditions listed .171

.592 Growth retardation, secondary

                    exclude: conditions listed .172

.593 Hypophosphatasia

.594 Hemochromatosis

.595 Alkaptonuria (ochronosis)

.596 Phenylketonuria

.597 Homocystinuria (see also with cardiovascular abnormality 5.1973)

.599 Other

                    include: idiopathic hypercalcemia of infancy congenital hyperuricemia (Lesch-Nyhan syndrome) (see 496)

                    exclude: arthritis (.7)

.61 CONNECTIVE TISSUE DISORDER

.612 Lupus erythematosus

.613 Progressive systemic sclerosis (scleroderma)

.6131 Osseous change

.6132 Soft tissue change

.6139 Other

                    include: diffuse fasciitis with eosinophilia

.614 Dermatomyositis, polymyositis

                    exclude: arthritis (.7)

.62 VASCULITIS

.621 Polyarteritis (periarteritis) nodosa

.629 Other

                    include: mucocutaneous lymph node syndrome

.63 ALLERGIC STATE

.64 COMPLICATION OF DRUG THERAPY, DRUG USE

                    include: methotrexate, prostaglandin (periostitis)

                    exclude: hypervitaminosis (.583),phenytoin (Dilantin) therapy (.5729), steroid (.542)

.65 HEMATOLOGICAL DISORDER

.651 Sickle cell disease or variant

.652 Thalassemia or-variant

.653 Other congenital (primary) anemia

                    include: erythroblastosis, Fanconi, spherocytosis, thrombocytopenia absent radius, Diamond-Blackfan

.654 Iron deficiency anemia

.655 Other acquired (secondary) anemia

.656 Hemophilia

.6561 Joint or soft tissue change

.6562 Osseous change

                    exclude: pseudotumor (.6563)

.6563 Pseudotumor

.6569 Other

.657 Myeloproliferative disorders

.6571 Polycythemia vera

.6572 Idiopathic myelofibrosis

.6579 Other

.658 Marrow Extinction disorder

.6581 Aplastic anemia (primary or idiopathic

.6582 Drug-induced myelosuppression

.6583 Radiation-induced fatty change (or conversion)

.6584 Premature fatty change (or conversion)

.6589 Other

.659 Other

                    include: extramedullary hematopoiesis exclude: leukemia (.341)

.66 HISTIOCYTOSIS (LANGERHANS CELL HISTIOCYTOSIS)

.661 Letterer-Siwe disease

.662 Hand-Schuller-Christian disease

.663 Eosinophilic granuloma

.669 Other

.67 SPHINGOLIPIDOSIS

.671 Gaucher disease

.672 Neimann-Pick disease

.673 Tay-Sachs disease

.679 Other

                    include: Fabry disease, Farber disease

                    exclude: GM1 gangliosidosis (.1824) Sandhoff disease (.1829)

.68 OTHER INFILTRATIVE DISORDER

                    include: amyloid

                    exclude: Wilson disease (.5729)

.69 MISCELLANEOUS

.695 Infantile cortical hyperostosis (Caffey)

.699 Other

                    include: mastocytosis (urticaria pigmentosa), epidermolysis bullosa, pemphigus

.71 RHEUMATOID ARTHRITIS

.711 Typical manifestation

.712 Unusual manifestation

.713 Juvenile

.719 Other

.72 PSORIATIC ARTHRITIS

.721 Typical psoriatic arthritis

.722 Psoriasis with features of psoriatic and rheumatoid arthritis

.723 Psoriasis with changes of classical rheumatoid arthritis

.729 Other

.73 REITER SYNDROME

.75 GOUT

.76 CHONDROCALCINOSIS

.761 Pseudogout

.762 Secondary to other disease (also code cause)

                    exclude: alkaptonuria (ochronosis) (.595)

.77 DEGENERATIVE JOINT DISORDER

.771 Typical

.772 Erosive osteoarthritis (acute)

.773 Unusual manifestation

.777 Diffuse idiopathic skeletal hyperostosis (DISH)

.779 Other

                    include: post-traumatic degenerative joint disorder

                    exclude: gout (.75), hemophilia (.656), nontraumatic hydrarthrosis (.254), loose body (.48)

.781 Ankylosis (also code cause)

.782 Osteochondromatosis

.783 Synovial herniation

                    include: Baker cyst

.784 Pigmented villonodular synovitis (giant cell tumor of tendon sheath)

.785 Synovitis, nonspecific

.786 Protrusio acetabuli (also code cause)

.787 Relapsing polychondritis

.789 Other

                    include: contracture, Wilson disease (see .5729,  1.592)

                    exclude: traumatic hydrarthrosis or hemarthrosis (.492)

.79 MISCELLANEOUS

                    include: Jacoud arthritis, arthritis with Crohn disease

                    exclude: hemochromatosis (.594), alkaptonuria (ochronosis) (.595)

.811 Calcified hematoma, fibrodysplasia (myositis) ossificans

                    exclude: fibrodysplasia ossificans progressiva (.1611)

.812 Calcified blood vessel, phlebolith

.813 Interstitial calcification of metabolic origin

                    include: calcinosis, fat necrosis, milk-alkali syndrome

.814 Calcified articular cartilage exclude: alkaptonuria (ochronosis) (.595), chondrocalcinosis (.76), pseudogout (.761)

.815 Calcification or ossification secondary to thermal injury, infection, venous stasis

.816 Calcified lymph node

.817 Calcification in neoplasm

.818 Tumoral calcinosis

.819 Other

                    include: calcification in paraplegic, collagen disorder, parasite, medication (e.g., extravasation of calcium gluconate)                    

                    exclude: bursitis (.251), tendinitis (.253), bone changes of collagen disorder (.61, .62, .71), osteochondromatosis (.782)

.821 Neuropathic skeletal disorder

                    include: neurosyphilis, syringomyelia, leprosy, diabetes, congenital indifference to pain

.822 Neurotrophic skeletal disorder include: thermal injury, diabetes, vascular disease, Werner syndrome (see .815) exclude: dermatomyositis (.614), scleroderma (.613)

.829 Other change secondary to neurological disorder

                    include: cerebral palsy, birth injury, mental retardation, postparalytic change

                    exclude: muscular dystrophy (.831), arthrogryposis (.1893)

.831 Muscular dystrophy

.832 Myopathy

.833 Edema, soft tissue swelling

                    include: anasarca, hydrops (soft tissue), lymphedema

                    exclude: inflammatory (.24), traumatic (.491)

.837 Obesity

.838 Emaciation

.839 Other

                    include: elephantiasis

                    exclude: arthrogryposis (.1893)

.84 PAGET DISEASE

.841 Destructive phase

.842 Mixed phase

.843 Bone forming phase

.849 Other

                        exclude: pathological fracture (.416), other complication (code specifically)

.85 FIBROUS DYSPLASIA

.852 Polyostotic

                    include: McCune-Albright syndrome

                    exclude: cherubism (243.1545)

.861 Hypertrophic osteoarthropathy

.862 Osteitis, periostitis or hyperostosis of unknown etiology

.863 Osteitis condensans ilii

.869 Other

                    include: ainhum

                    exclude: periosteal reaction associated with vascular insufficiency (.29)

.87 RIB NOTCHING, EROSION

.871 Rib notching (also code cause)

.872 Erosion of superior aspect of rib (also code cause)

.879 Other

            (e.g., displaced fat pad)

.92 ANATOMICAL DETAIL

                    include: normal bone growth and maturation

.93 ARTIFACT

.94 ERROR IN DIAGNOSIS

.99 OTHER

                    include: phenomenon related to technique of examination

                    exclude: "vacuum joint" (.137)