Orthopedic Coding: Acute Versus Chronic Injury

By Author: Julia Rose
Total Articles: 89
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While lifting a heavy object at his work, a person suffers a rotator cuff strain. The orthopedist tends to the patient for several months. Ultimately, the orthopedist determines the patient actually has a torn rotator cuff that calls for surgery.


But how will you differentiate an acute injury from a chronic one? Is it possible for the patient to upgrade from an acute condition to a chronic one?


First of all you need to distinguish what acute and chronic means. An acute condition is sudden and severe. Normally, an acute injury is an injury which took place within the last 90 days. Initially, you can assign 840.4 (Sprain/strain rotator cuff [capsule]) to signify the acute injury.


On the other hand, a chronic condition is a longer developing syndrome, which persists or recurs, but may have been caused by an acute injury. You need to list the patient's condition - the complete rotator cuff rupture (727.61, Nontraumatic complete rupture of rotator cuff) - as the primary diagnosis. Report 905.7 (Late effect of sprain and strain without mention of tendon injury) as the secondary ...
... code to help create a connection between the two conditions.


Upgrading an acute condition to a chronic one depends on the insurance company. Normally physicians treat such acute conditions as rotator cuff strains conservatively and the patient responds to it. However, in some cases the conservative treatment might not work and the patient might require surgery, at which point the condition needs to be upgraded to a chronic one.


For more of such orthopedic coding know-how and orthopedic coding updates, attend coding conferences pertaining to your specialty and spare yourself the pains of incorrect coding.


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