Degenerative Joint Disease And Degenerative Disc Disease



Degenerative Joint Disease (DJD) or osteoarthritis is characterized by the breakdown of joint cartilage and may affect any joint in the body. There is no cure for osteoarthritis, but medications can relieve the symptoms.   The most common symptoms include, but are not limited to, pain associated with use or inactivity,  discomfort in joints due to change in weather, swelling and stiffness, bony lumps in joints, and  loss of joint flexibility.  Osteoarthritis of all joints—except the spine—is classified to ICD-9-CM category 715. The fourth digit subcategory classifies the type of osteoarthritis such as generalized, localized, primary, secondary or unspecified.  The fifth digit sub-sub category (1-8) classifies the specific anatomic site (i.e. 715.96 would be osteoarthritis of the knee, unspecified whether generalized or localized). 


Spondylosis is a general term for degenerative changes of the spine due to osteoarthritis.  The ICD-9 codes for spondylosis are the 721.0-721.42 series.  The code selection is based upon the location of the condition and whether or not myelopathy is present


Degenerative Disc Disease (DDD) is a gradual process that may compromise the spine. It is a relatively common disorder.  Degenerative changes to a spinal disc often refer to those changes that cause the loss of normal structure and/or function. The intervertebral disc is one structure prone to the degenerative changes associated with wear and tear such as aging, weight bearing, injury as well as misuse (e.g. smoking).  These changes are linked and may lead to the disc’s inability to handle mechanical stress. Because the lumbar spine carries a large portion of the body’s weight; the stress from motion may result in a disc problem. 


The ICD-9 category used for this condition is dependent upon the site.  722.4 is the correct code for degenerative disease of the cervical intervertebral disc.  722.51 is the correct diagnosis code for thoracic degenerative disc disease.  722.52 is the accurate diagnosis code for DDD of the lumbar or lumbosacral intervertebral disc.  Other terms used to describe DDD are disc desiccation and discogenic spondylosis.  It also can be commonly described as an aggravation of a pre-existing condition of DDD.


BWC policy when using these ICD-9 codes is to require a file review considering consequences of diagnosis and aggravation of a pre-existing condition.  It may also be necessary to require an IME, an MRI or CT scan, plus x-ray.