1. Musculoskeletal System
HIT241 – Advanced CPT Coding
Chapter 12

2. Anatomy of the Musculoskeletal System

3. Anatomy of the Musculoskeletal System

4. Anatomy of the Musculoskeletal System

5. Anatomy of the Vertebrae
Note the interspaces and the anatomy.

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

7. 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.

8. 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

9. 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

10. 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

11. 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

12. 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

13. 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

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

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

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

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

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

19. Types of Fractures
Femoral head fracture and Greenstick fracture.

20. Types of Fractures
Compression fracture and femoral longitudinal fracture.

21. Types of Fractures
Patella and skull fracture.

22. 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.

23. Cranial Halo
Pay attention to global or unbundling.

24. Fracture Procedures
External and internal fixation.

25. Fracture Procedures
External fixation devices.

26. Fracture Procedures
Healing site of fixation device and external fixation.

27. Fracture Procedures
ORIF

28. LeFort Facial Procedures
LeFort I, II and III.

29. Temporomandibular Joint
Fractures, bone grafts, arthroplasty, reconstruction.

30. 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.

31. Cervical Arthrodesis
Anterior and posterior approach.

32. Spinal Deformities

33. Spinal Deformities
Scoliosis braces worn under clothing.

34. Spinal Deformities
Milwaukee brace is worn outside of clothing.

35. Spinal Prosthetic Devices
Vertebral disc and disc prosthetics.

36. Shoulder Procedures
Shoulder manipulation and manipulation under anesthesia (MUA)

37. Hip Anatomy and Procedures
Hip anatomy and hip replacement tools.

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

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

40. Fixation of the Tibia and Fibula

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

42. Bunions
Bunion correction procedure depends on bunion deformity.

43. More Bunions

44. Casts
Note the requirements for global or unbundling.

45. Casts
Long and short leg casts.
Minerva type cast.

46. Splints
Dynamic and static splints.

47. Strapping
Ankle and shoulder strapping.

48. 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).

49. Arthroscopic and Endoscopic Procedures
Total Knee Replacement
Open Knee surgery.

50. Arthroscopic and Endoscopic Procedures