An integral part of the body, the hip joint connects the torso to the lower extremities. Disorder or injury within the hip can be problematic both locally and globally, and so must be treated appropriately to ease pain and suffering in many individuals. As part of this article, we examine several conditions of the hip that can be treated with physical therapy, as well as the ICD-10 codes that cover treatments for the hip.
Osteoarthritis of the hip
A degenerative joint disease, osteoarthritis slowly damages the joint over time. A form of hip arthritis that can also affect other joints, it is the most common form of arthritis in the hip. A person who has hip osteoarthritis typically develops it as they age and it worsens over time as a result of wear and tear. Inflammation and pain are caused by cartilage breakdown.
It is possible for hip osteoarthritis to develop faster in some people due to irregular shapes of the bones that form the hip joint. As an example, if the ball and socket parts of the hip joint don't fit perfectly together (a condition known as hip impingement), they may rub against each other, eventually leading to osteoarthritis. It may also happen to people with hip dysplasia, who have a shallow hip socket that cannot support the ball of the femur. It causes cartilage to wear away prematurely as a result of abnormal stress.
A variety of treatment options are available for hip arthritis, depending on its type, stage, severity, age, and other factors. There are ways to reduce pain and prevent further cartilage damage, despite the fact that doctors cannot restore cartilage. There are several non-surgical and physical therapy related treatments that are often prescribed for patients recently diagnosed with osteoarthritis of the hip. In the event that these treatments are unsuccessful or if the patient’s condition continues to deteriorate, surgical interventions such as total hip replacement are often prescribed.
Here are ICD-10 codes associated with Osteoarthritis of the hip:
M16 Osteoarthritis of hip
M16.0 Bilateral primary osteoarthritis of hip
M16.1 Unilateral primary osteoarthritis of hip
M16.10 Unilateral primary osteoarthritis, unspecified hip
M16.11 Unilateral primary osteoarthritis, right hip
M16.12 Unilateral primary osteoarthritis, left hip
M16.2 Bilateral osteoarthritis resulting from hip dysplasia
M16.3 Unilateral osteoarthritis resulting from hip dysplasia
M16.30 …… unspecified hip
M16.31 …… right hip
M16.32 …… left hip
M16.4 Bilateral post-traumatic osteoarthritis of hip
M16.5 Unilateral post-traumatic osteoarthritis of hip
M16.50 Unilateral post-traumatic osteoarthritis, unspecified hip
M16.51 Unilateral post-traumatic osteoarthritis, right hip
M16.52 Unilateral post-traumatic osteoarthritis, left hip
M16.6 Other bilateral secondary osteoarthritis of hip
M16.7 Other unilateral secondary osteoarthritis of hip
M16.9 Osteoarthritis of hip, unspecified
Sacroiliac joint pain
Located in the pelvis, there are two sacroiliac joints that connect the sacrum (tailbone) with the ilium (large pelvic bone). Your SI joints connect your spine to your pelvis and, therefore, to your lower half of your skeleton. As with other joints, the SI joint surfaces are covered by articular cartilage. However, unlike most joints, the SI joints have two types of cartilage. Hyaline (slick, glassy) and fibrocartilage (spongy) surfaces rub against each other on the articular surfaces. In addition, there are many large ridges (bumpy surfaces) and depressions (dips in the surface).
SI joints can develop degenerative arthritis as a result of many problems. Sometimes it is hard to determine what causes joint wear and tear. An injury to the SI joint is a common cause of problems. You can sustain an injury to the buttocks by falling, being involved in a motor vehicle accident, or getting hit on the side of the pelvis. Due to these injuries, ligaments around joints can be strained. Another frequent cause of SI joint pain or injury is pregnancy.
The treatment depends on the stiffness or looseness of the SI joint. Joints that are stiff or "locked" respond best to mobilization. Mobilizations help improve joint movement by stretching joints. In addition to hands-on treatment, the therapist uses mobilization techniques. Exercises that improve SI joint mobility are included in these techniques.
When joints become too loose due to conditions like arthritis or SI ligament injuries, stabilization treatments should be chosen to maintain correct alignment. As part of stabilization exercises, muscles must be trained and posture must be maintained.
SI joint problems are commonly treated with physical therapy. Rehabilitation helps soothe pain and inflammation, improve mobility and strength, and allow you to perform your daily activities with greater ease.
Here are many of the ICD-10 codes associated with sacroiliac joint pain:
M43.8X8 Other specified deforming dorsopathies, sacral and sacrococcygeal region
M99.54 Intervertebral disc stenosis of neural canal of sacral region
M99.64 Osseous and subluxation stenosis of intervertebral foramina of sacral region
S34.02XA Concussion and edema of sacral spinal cord, initial encounter
S34.02XD Concussion and edema of sacral spinal cord, subsequent encounter
S34.1 Other and unspecified injury of lumbar and sacral spinal cord
S34.132D Incomplete lesion of sacral spinal cord, subsequent encounter
S34.139D Unspecified injury to sacral spinal cord, subsequent encounter
S34.5XXS Injury of lumbar, sacral and pelvic sympathetic nerves, sequela
M79.6 Pain in limb, hand, foot, fingers and toes
M45.8 Ankylosing spondylitis sacral and sacrococcygeal region
Bursitis
Inflammation of the bursa is called bursitis. Bursae are closed, fluid-filled sacs that reduce friction between body tissues by acting as a cushion and gliding surface. Near large joints, such as the shoulders, elbows, hips, and knees, major bursae (plural of bursa) are located near tendons.
Most bursitis cases are temporary. In general, it does not cause deformity, but may limit motion.
There are various types of bursitis, but hip bursitis is one of the most common. Injuries, overuse, spinal abnormalities, arthritis, or surgery can cause hip bursitis, also known as trochanteric bursitis. The incidence of this type of bursitis is higher in women and middle-aged and older individuals.
Hip bursitis can be effectively treated by physical therapists. In order to get people back to their daily routines, they work with them to reduce pain and irritation. A physical therapist will also address any weakness in the hip, back, or lower extremities that may contribute to the condition.
Hip bursitis ICD-10 codes:
M70 Soft tissue disorders related to use, overuse and pressure
M70.7 Other bursitis of hip
557 Tendonitis, myositis and bursitis with mcc
558 Tendonitis, myositis and bursitis without mcc
Labral tear
In the hip joint, a labral tear is an injury to the cartilage ring on the socket part of the joint. Hip joints are ball-and-socket joints, with a ball at the top of your femur (femoral head) and a socket at the bottom of your pelvis (acetabulum). In movement, the labrum helps to keep the bones of the hip joint aligned and in place. Furthermore, it ensures frictionless motion by keeping joint fluid inside.
There can be a wide range of severity when it comes to hip labral tears. In some cases, hip labrums can have small tears or frays along the edges. In most cases, this is caused by a gradual wearing down of the labrum. It is also possible for a portion of the hip labrum to separate or tear away from the socket bone in other cases. Trauma usually causes hip labrum injuries of this type.
Often, hip labral tears can be treated in physical therapy, but sometimes surgery will be required. Under the guidance of a physical therapist, you can do torn hip labrum exercises that will effectively treat a hip labral tear and eliminate pain in the hip.
ICD-10 codes used to treat Labral tears of the hip:
S73.192A Other sprain of left hip initial encounter - Left hip labrum tear
S73.191A Other sprain of right hip initial encounter - Right hip labrum tear
S73.199A Other sprain unspecified hip initial
Femoroacetabular impingement
An impinged hip, also known as a femoroacetabular impingement (FAI), occurs when the femoral head (hip ball) presses against the acetabulum (hip cup). The labrum (cartilage surrounding the acetabulum) can be damaged when this happens, causing hip stiffness and pain.
FAI can be classified into two main types. The first type is caused by a deformity of the femoral head (ball). This type of impingement results in a ball that appears more oval than round. Whenever the ball hits the cup's edge, friction is created. The acetabulum (cup) can also impinge if it has an abnormal shape. In some cases, the cup may cover the head of the femur too much, causing friction when the edge of the cup falls on the head/neck. Combinations of these two types are also possible.
Physical therapy is recommended when an active person develops hip pain without severe symptoms or joint damage. By strengthening the strength of hips and trunk some patients can help decrease pain, improve movement, and avoid the progression of hip impingement and the need for surgery. In addition, many therapists work on hip flexibility and joint mobilization with their patients experiencing FAI to stave off surgery. Improving the strength of your hips and trunk. When providing advice to patients regarding postures that are healthy for their hips and activity modifications, physical therapists take into account their job and recreational activities. The most common way to prevent further hip damage is to limit hip bending.
ICD-10 codes used for FAI impingement:
M24 Other specific joint derangements
M24.8 Other specific joint derangements, not elsewhere classified
M24.85 Other specific joint derangements of hip, not elsewhere classified
564 Other musculoskeletal system and connective tissue diagnoses with mcc
565 Other musculoskeletal system and connective tissue diagnoses with cc
566 Other musculoskeletal system and connective tissue diagnoses without cc/mcc
Hip flexor strains
The hip flexors connect the top of the femur, which is the largest bone in the body, to the lower back, hips, and groin. There are various hip flexor muscles that all work to enable a person to move.
They include:
the iliacus and psoas major muscles that are also referred to as iliopsoas
the rectus femoris, which is part of a person’s quadriceps
Overuse or overstretching of these muscles and tendons can result in injury, accompanying pain, and reduced mobility.
Damage to the hip area can vary from minor injuries that require little treatment to more severe injuries that result in the muscles disconnecting from the bone. The most serious hip flexor injuries are third-degree sprains where the bone breaks alongside the muscle sprain.
Recovery time for minor tears to hip flexors takes around two or three weeks. More significant tears can take up to six weeks. Severe hip injuries and tears can take closer to eight weeks to heal. These times are based on working closely with your physical therapist and following their instructions. In most cases, physical therapists can prescribe rehabilitative exercises depending on the severity of the strain. In severe cases surgery may be recommended.
Strain of the hip flexor ICD-10 codes:
S76.019A Strain of muscle, fascia and tendon of unspecified hip, initial encounter
S76.011A Strain of muscle, fascia and tendon of right hip, initial encounter
S76.011S Strain of muscle, fascia and tendon of right hip, sequela
S76.012A Strain of muscle, fascia and tendon of left hip, initial encounter
S76.012S Strain of muscle, fascia and tendon of left hip, sequela
IT band strains
An iliotibial band syndrome occurs when your hip or knee bones rub against a tendon called the iliotibial band. From the top of the pelvic bone down to your knee, this tendon runs along the outside of your leg. During times of tension, it rubs against your bones and takes on a tightness that is extremely painful. The iliotibial band may tighten for a variety of reasons.
The initial pain of iliotibial band syndrome is described as aching and burning. As the syndrome progresses, and the leg exercises become more challenging, the pain becomes more intense.
The treatment of iliotibial band syndrome can vary from home-based treatments to healthcare providers-based treatments. In addition to rest and over-the-counter pain medications, manual therapy is also commonly used to treat this condition. Physical therapy may be recommended in some cases. Stretching exercises and strengthening exercises can help relieve hip and knee pain with the help of a physical therapist. In addition to lengthening the iliotibial band, these treatments may also reduce tension in the band. Additionally, a physical therapist can advise those suffering from more severe IT band strain on how to warm up for exercise and cool down afterwards.
ICD-10 codes used to diagnose and treat Iliotibial band syndrome:
M76.3: Iliotibial band syndrome, unspecified leg
M76.31: Iliotibial band syndrome, right leg
M76.32: Iliotibial band syndrome, left leg
As a physical therapist, you know that all of the muscles, ligaments and tendons of the body work together. Check out our comprehensive guides to ICD-10 codes for the knee, foot and ankle, and keep checking in as we move through every area of the body. Book a demo with PatientStudio to see other ways that we can make your charting and billing even easier.