Musculoskeletal System HIT241 – Advanced CPT Coding Chapter 12

Anatomy of the Musculoskeletal System

Anatomy of the Musculoskeletal System

Anatomy of the Musculoskeletal System

Anatomy of the Vertebrae Note the interspaces and the anatomy.

Structure of a Long Bone Shaft AKA diaphysis. Ends of bone AKA epiphysis is where the growth plate is located.

Structures of the Musculoskeletal System Bones-Provide posture and structure to the body. Muscles-Allows for skeletal movement. Tendons-Connect muscles to bones. Ligaments-Connects bones. Cartilage-Located between joints. Fascia-Connects muscles to the skin.

Medical Terminology of the Bones Bone- Oste/o Calcium- Calcic/o, calc/o Cranium (Skull)- Crani/o Upper Jaw- Maxill/o Lower Jaw- Mandibul/o Neck- Cervic/o Shoulder- Scapul/o Collar bone- Clavic/o, Calvicu/o Ribs- Cost/o Breast bone- Stern/o Upper Arm- Humer/o Lower Arm(lateral)- Radi/o

Medical Terminology of the Bones Lower Arm (medial)- Uln/o Elbow- Olecran/o Wrist- Carp/o Hand- Metacarp/o Fingers- Phalang/o Hip- Pelv/o Hip Socket- Acetabul/o Pubis- Pub/o Ischium- Ischi/o Ilium-Ili/o Thighbone- Femor/o

Medical Terminology of the Bones Shinbone (medial)- Tibi/o Fibula (lateral)- Fibul/o, Perone/o Ankle- Tars/o Process on lateral ankle- Malleol/o Foot- Metatars/o Toes- Phalang/o Knee Cap- Patell/o Heel- Calcane/o Sole of the Foot- Plant/o

Medical Terminology of the Bones Spine- Rachi/o Vertebra- Vertebr/o, Spondyl/o Lower back- Lumb/o Sacrum- Sacr/o Thoracic- Thorac/o Intervertebral Disc- Disc/o Lamina- Lamin/o Bent- Scoli/o Fused/Bent-Ankyl/o Curve- Lord/o Hump- Kyph/o

More Medical Terminology that pertains to other Musculoskeletal Structures Joint- Articul/o, arthr/o Fluid-filled sac- Burs/o Cartilage- Chondr/o Meniscus- Menisc/o, Menisci/o Muscle- My/o, Muscul/o Synovial Joint Membrane- Synovi/o Tendon- Ten/o, Tend/o, Tendin/o

Abbreviations Fx- Fracture OA- Osteoarthritis RA- Rheumatoid Arthritis TMJ-Temporomandibular Joint AKA- Above Knee Amputation BKA-Below Knee Amputation C1-C7-Cervical Vertebrae T1-T12- Thoracic Vertebrae L1-L5- Lumbar Vertebrae S1-Sacral Vertebra CTS- Carpal Tunnel Syndrome THR- Total Hip Replacement TKR-Total Knee Replacement ORIF-Open Reduction with Internal Fixation

Modifiers RT and LT FA, F1-F9 TA, T1-T9 50 58

Anatomy of a Long Bone It is important to know the location of the fracture when coding bone fractures

Introduction or Removal (Injection Procedures) Ganglion cyst and Trigger points injections sites.

Types of Fractures Simple AKA Closed-Skin unbroken Open AKA Compound- Skin broken

Types of Fractures Colles fracture- Distal radius fracture from trying to stop a fall. Comminuted fracture AKA Fragmented fracture.

Types of Fractures Femoral head fracture and Greenstick fracture.

Types of Fractures Compression fracture and femoral longitudinal fracture.

Types of Fractures Patella and skull fracture.

Procedures Soft tissue procedures are performed on muscle tissue. Closed or open treatment with or without manipulation. Percutaneous fixation-external fixation Internal fixation devices Manipulation Manipulation Under Anesthesia NOTE: The type of fracture does not have any coding correlation with the type of treatment provided. For example closed fx does not necessarily receive closed treatment. Injection Procedures-painful knots in the muscles.

Cranial Halo Pay attention to global or unbundling.

Fracture Procedures External and internal fixation.

Fracture Procedures External fixation devices.

Fracture Procedures Healing site of fixation device and external fixation.

Fracture Procedures ORIF

LeFort Facial Procedures LeFort I, II and III.

Temporomandibular Joint Fractures, bone grafts, arthroplasty, reconstruction.

Spinal Column Procedures Spinal Instrumentation (Arthrodesis) Spinal arthrodesis with instrumentation. Segmental versus non-segmental instrumentation-proximal and distal hooks versus proximal, distal and intermediate hooks.

Cervical Arthrodesis Anterior and posterior approach.

Spinal Deformities

Spinal Deformities Scoliosis braces worn under clothing.

Spinal Deformities Milwaukee brace is worn outside of clothing.

Spinal Prosthetic Devices Vertebral disc and disc prosthetics.

Shoulder Procedures Shoulder manipulation and manipulation under anesthesia (MUA)

Hip Anatomy and Procedures Hip anatomy and hip replacement tools.

Hip Fracture and Partial Hip Replacement. Fracture at femoral neck and partial hip replacement.

Total Hip Replacement Note that the femur length determines the type of replacement-THR or PHR. Note closed, open or percutaneous treatment.

Fixation of the Tibia and Fibula

Toe Problems Hallux Malleus (Hammer Toe) and Hallux Valgus (bunions).

Bunions Bunion correction procedure depends on bunion deformity.

More Bunions

Casts Note the requirements for global or unbundling.

Casts Long and short leg casts. Minerva type cast.

Splints Dynamic and static splints.

Strapping Ankle and shoulder strapping.

Arthroscopic and Endoscopic Procedures Anatomy of knee-Medial and Lateral meniscus OR Medial or Lateral meniscus. Note the instruments used in the procedure. Camera and probes (Trocar).

Arthroscopic and Endoscopic Procedures Total Knee Replacement Open Knee surgery.

Arthroscopic and Endoscopic Procedures