Musculoskeletal condition M71.349 — ICD-10 M71.349
Musculoskeletal condition M71.349
Overview
M71.349 refers to "Other bursitis, unspecified site," which is a musculoskeletal condition characterized by inflammation of the bursa—a small fluid-filled sac that acts as a cushion between bones and soft tissues. Bursitis can occur in various locations throughout the body, but this specific ICD-10 code is used when the exact site of inflammation is not specified. This condition often results from repetitive motion, trauma, or underlying inflammatory diseases and can significantly impair mobility and function.
Bursae are located throughout the body, particularly in joints such as the shoulder, elbow, hip, knee, and heel. They serve to reduce friction between moving parts—such as tendons, muscles, and bones—during movement. Understanding the anatomy of these structures is crucial for diagnosing and treating bursitis.
Key Anatomical Structures:
- Subacromial Bursa: Located beneath the acromion in the shoulder.
- Olecranon Bursa: Found at the elbow, cushioning the olecranon process.
- Trochanteric Bursa: Situated near the hip joint.
- Prepatellar Bursa: Located in front of the kneecap.
- Achilles Bursa: Found at the heel, protecting the Achilles tendon.
Biomechanics:
The bursa facilitates smooth gliding movements during physical activities. When excessive force or repetitive strain is applied to a joint, it may lead to irritation and inflammation of these structures. Understanding these mechanics is vital for rehabilitation strategies aimed at restoring normal function.
Comman symptoms
Early Stage (Mild):
- Localized tenderness at the site of inflammation.
- Slight swelling may be present.
- Pain with specific movements but generally tolerable.
Moderate Stage:
- Increased swelling and warmth over the affected area.
- Pain becomes more pronounced during movement and at rest.
- Limited range of motion may develop.
Severe Stage:
- Significant swelling and redness around the joint.
- Severe pain that may radiate beyond the localized area.
- Marked limitation in mobility and function; inability to perform daily activities.
Red Flag
Clinicians should be vigilant for red flags indicating more serious conditions requiring immediate referral:
- Severe joint pain not relieved by rest or medication.
- Fever accompanying joint symptoms, suggesting infection.
- Rapid swelling or significant redness around a joint.
- Persistent symptoms despite conservative management for more than 4–6 weeks.
Referral to an orthopedic specialist may be warranted if there is suspicion of septic bursitis or other serious underlying conditions.
At a Glance
ICD-10: M71.349 | Category: Soft Tissue Disorders | Billable: Yes
Overview
M71.349 refers to "Other bursitis, unspecified site," which is a musculoskeletal condition characterized by inflammation of the bursa—a small fluid-filled sac that acts as a cushion between bones and soft tissues. Bursitis can occur in various locations throughout the body, but this specific ICD-10 code is used when the exact site of inflammation is not specified. This condition often results from repetitive motion, trauma, or underlying inflammatory diseases and can significantly impair mobility and function.
Bursae are located throughout the body, particularly in joints such as the shoulder, elbow, hip, knee, and heel. They serve to reduce friction between moving parts—such as tendons, muscles, and bones—during movement. Understanding the anatomy of these structures is crucial for diagnosing and treating bursitis.
Key Anatomical Structures:
- Subacromial Bursa: Located beneath the acromion in the shoulder.
- Olecranon Bursa: Found at the elbow, cushioning the olecranon process.
- Trochanteric Bursa: Situated near the hip joint.
- Prepatellar Bursa: Located in front of the kneecap.
- Achilles Bursa: Found at the heel, protecting the Achilles tendon.
Biomechanics:
The bursa facilitates smooth gliding movements during physical activities. When excessive force or repetitive strain is applied to a joint, it may lead to irritation and inflammation of these structures. Understanding these mechanics is vital for rehabilitation strategies aimed at restoring normal function.
Causes & Risk Factors
Bursitis typically arises from two main processes: acute trauma or chronic overuse. The inflammation occurs when the bursa becomes irritated due to mechanical stress or underlying systemic conditions.
Causes:
- Repetitive Motions: Common in athletes or occupations requiring repetitive arm or leg movements.
- Trauma: Direct impact or injury to a joint can lead to bursitis.
- Infection: Septic bursitis can occur if bacteria invade the bursa.
- Systemic Conditions: Conditions like rheumatoid arthritis or gout can predispose individuals to bursitis.
Risk Factors:
- Age: Older adults are more susceptible due to degenerative changes in joints.
- Occupation: Jobs involving repetitive motions (e.g., painting, construction).
- Sports: Activities that require overhead motions (e.g., swimming, tennis).
- Obesity: Increased body weight places additional stress on joints.
Diagnostic Workup
A thorough clinical evaluation is essential for diagnosing M71.349 bursitis. The following steps are typically undertaken:
History Taking:
- Assessing the onset, duration, and nature of symptoms.
- Inquiry about previous injuries, occupations, and physical activities.
Physical Examination:
- Inspection for swelling, redness, or deformity.
- Palpation to identify tenderness over bursal sites.
- Range of motion tests to assess functional limitations.
Diagnostic Imaging:
- X-rays: To rule out fractures or bone spurs.
- Ultrasound: Useful for visualizing fluid accumulation in the bursa.
- MRI: Provides detailed images of soft tissue structures.
Treatment & Rehabilitation
Effective management of M71.349 involves both conservative measures and rehabilitation exercises tailored to the severity of symptoms.
Phase 1: Acute Management
Goals: Reduce pain and inflammation.
- Rest: Avoid activities that exacerbate symptoms.
- Ice Therapy: Apply ice packs for 15–20 minutes several times a day.
- Non-steroidal Anti-inflammatory Drugs (NSAIDs): Ibuprofen or naproxen can help alleviate pain.
Phase 2: Restoration of Range of Motion
Goals: Gradually restore movement without pain.
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Exercises:
- Pendulum Swings (for shoulder bursitis): Lean forward and let the arm swing gently in circles.
- Heel Slides (for knee bursitis): While lying down, slide the heel towards the buttocks while keeping the foot on the ground.
Phase 3: Strengthening
Goals: Build strength around the affected joint.
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Exercises:
- Isometric Shoulder Presses: Push against a wall without moving the shoulder joint.
- Straight Leg Raises (for hip bursitis): Lying on your back, lift one leg straight up without bending the knee.
Phase 4: Functional Training
Goals: Return to normal activities safely.
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Exercises:
- Wall Push-ups (for shoulder): Stand a few feet from a wall and perform push-ups against it.
- Step-ups (for knee/hip): Step onto a low platform or step with one foot then return down.
Prevention
Preventing musculoskeletal conditions such as those classified under ICD-10 code M71.349, which pertains to other specified disorders of bursae and tendons, requires a multifaceted approach. Evidence-based strategies include:
- Ergonomics: Implement ergonomic assessments in the workplace. Encourage proper posture, workstation adjustments, and the use of supportive equipment to reduce strain on the musculoskeletal system.
- Lifestyle Modifications: Promote regular physical activity to maintain flexibility and strength in muscles and joints. Incorporate stretching exercises into daily routines, especially for individuals engaging in repetitive tasks.
- Risk Management: Identify high-risk activities and develop protocols for safe execution. Encourage breaks during repetitive tasks to minimize overuse injuries. Additionally, educate employees on the correct lifting techniques to avoid strain on the back and joints.
Coding Examples
Patient presents with pain and inflammation in the right shoulder, diagnosed as bursitis not otherwise specified. Code as M71.349 because this code is used when the specific type of bursitis is not documented, and there is no other specific diagnosis available.
Audit & Compliance
To support medical necessity and prevent claim denials for ICD-10 code M71.349, the following key documentation elements are required:
- Thorough Clinical Documentation: Ensure that the patient’s history, physical examination findings, and specific symptoms are clearly documented.
- Diagnosis Specificity: Although M71.349 is for unspecified bursitis, the clinical rationale for using this code must be substantiated by the absence of more precise diagnoses.
- Treatment Plan: Document the treatment plan, including patient education, prescribed therapies, and follow-up measures, to demonstrate the medical necessity of the care provided.
- Progress Notes: Include regular updates on the patient’s condition and response to treatment to justify ongoing care and support the chosen code.
Clinical Example
Subjective: A 45-year-old female patient presents with complaints of persistent pain in her left shoulder that has worsened over the last two weeks. She reports difficulty in lifting her arm and discomfort at night. Objective: Upon examination, the left shoulder exhibits limited range of motion and tenderness located around the acromion. No signs of swelling or redness are noted. Assessment: Left shoulder bursitis, not specified (ICD-10 code M71.349). Plan: Advise the patient to rest the shoulder and apply ice for 15-20 minutes, three times a day. Recommend a follow-up appointment in two weeks for re-evaluation. If symptoms persist, consider a referral for physical therapy.
Differential Diagnoses
When diagnosing bursitis, it is crucial to differentiate it from other conditions that may present similarly:
- Tendinitis (ICD-10 M76): Inflammation of tendons that may mimic bursitis symptoms.
- Osteoarthritis (ICD-10 M15): Degenerative joint disease that can cause pain and swelling around joints.
- Rheumatoid Arthritis (ICD-10 M05): An autoimmune condition leading to joint inflammation.
- Septic Arthritis (ICD-10 M00): Infection within a joint that requires immediate attention.
Documentation Best Practices
Accurate documentation is essential for proper billing under ICD-10 code M71.349:
Key Documentation Points:
- Detailed patient history including onset, location, severity of symptoms, and response to treatment.
- Comprehensive physical examination findings documenting tenderness, swelling, range of motion limitations, etc.
- Results from imaging studies if performed should be included in EMR documentation.
Billing Considerations:
Ensure that all services rendered are documented clearly in EMR systems like SPRY EMR + RCM for seamless billing processes.
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