Guide to Physical Therapist Practice: Revisions.In November 1997, Physical Therapy published APTA's Guide to Physical Therapist Practice (Guide). As explained in its introduction, the Guide "represents expert consensus and contains preferred practice patterns describing common sets of management strategies used by physical therapists for selected patient/client diagnostic groups." The Guide is an evolving document. In April 1999, APTA APTA American Physical Therapy Association. published a revised edition that contains ICD-9-CM ICD-9-CM International Classification of Disease, 9th edition, Clinical Modification A standardized classification of disease, injuries, and causes of death, by etiology and anatomic localization and codified into a 6-digit number, which allows code corrections and clarifications of terms. Parts Three and Four of the Guide, scheduled for publication in 2000, will focus on a minimum data set for physical therapist examination and on the reliability and validity of measurements obtained using specific tests and measures. The following pages list revisions that have been made to the Guide since 1997. PDF (Portable Document Format) The de facto standard for document publishing from Adobe. On the Web, there are countless brochures, data sheets, white papers and technical manuals in the PDF format. versions of some of the revised Guide pages are available at APTA's Web site (http://www.apta.org). For more information about the Guide, contact APTA's Department of Practice at 800/999-2782, ext 3176, or write to GUIDE, Division of Practice and Research, d, 1111 North Fairfax Street, Alexandria, VA 22314-1488. The revised Guide is available through APTA's Service Center, ext 3395 or via e-mail at svcctr@apta.org. If you use the version of the Guide that was published in the November 1997 issue of Physical Therapy or the book version of the Guide that was published in 1997, please note the following changes (in shaded text): Musculoskeletal musculoskeletal /mus·cu·lo·skel·e·tal/ (-skel´e-t'l) pertaining to or comprising the skeleton and muscles. mus·cu·lo·skel·e·tal adj. Relating to or involving the muscles and the skeleton. Practice Patterns Pattern E: Impaired Joint Mobility Muscle Performance, and Range of Motion Associated With Ligament ligament (lĭg`əmənt), strong band of white fibrous connective tissue that joins bones to other bones or to cartilage in the joint areas. The bundles of collagenous fibers that form ligaments tend to be pliable but not elastic. or Other Connective connective - An operator used in logic to combine two logical formulas. See first order logic. Tissue Disorders
Page 4E-2
ICD-9-CM code 729 was incorrectly worded. It has been
changed to:
729 Other disorders of soft tissues
729.9 Other and unspecified disorders
of soft tissue
Imbalance of posture
Pattern F: Impaired Joint Mobility, Motor Function, Muscle Performance, and Range of Motion Associated With Localized Translated into the spoken language of the country. See localization. Inflammation
Page 4F-2
ICD-9-Cm code 726.6 was incomplete. It has been
change to:
726.6 Enthesopathy of knee
Bursitis of knee, not otherwise specific
726.60 Enthesopathy of knee, unspecified
Pattern G: Impaired Joint Mobility, Motor Function, Muscle Performance, Range of Motion, or Reflex Integrity Secondary to Spinal Disorders Page 4G-2 ICD-9-CM codes 723.0 and 724.0 were incorrectly worded. They have been changed to: 723.0 Spinal stenosis in cervical region 424.0 Spinal stenosis, other than cervical Pattern H: Impaired Joint Mobility, Muscle Performance, and Range of Motion Associated With Fracture
Page 4H-2
ICD-9-CM codes 715 and 821 were incorrectly worded.
They have been changed to:
715 Osteoarthrosis and allied disorders
821 Fracture of other and unspecified parts of
femur
Cardiopulmonary cardiopulmonary /car·dio·pul·mo·nary/ (kahr?de-o-pool´mah-nar-e) pertaining to the heart and lungs. car·di·o·pul·mo·nar·y adj. Of, relating to, or involving both the heart and the lungs. Practice Patterns Pattern C: Impaired Ventilation, Respiration respiration, process by which an organism exchanges gases with its environment. The term now refers to the overall process by which oxygen is abstracted from air and is transported to the cells for the oxidation of organic molecules while carbon dioxide (CO (Gas Exchange), and Aerobic aerobic /aer·o·bic/ (ar-o´bik) 1. having molecular oxygen present. 2. growing, living, or occurring in the presence of molecular oxygen. 3. requiring oxygen for respiration. 4. Capacity Associated With Airway airway /air·way/ (-wa) 1. the passage by which air enters and leaves the lungs. 2. a device for securing unobstructed respiration. Clearance Dysfunction dysfunction /dys·func·tion/ (dis-funk´shun) disturbance, impairment, or abnormality of functioning of an organ.dysfunc´tional erectile dysfunction impotence (2).
Page 6C-2
ICD-9-CM code 507.0 was incorrectly identified as
507.7 and has been changed to:
507.0 Due to inhalation of food or vomitus
Aspiration pneumonia
Pattern G: Impaired Ventilation With Mechanical Ventilation mechanical ventilation n. A mode of assisted or controlled ventilation using mechanical devices that cycle automatically to generate airway pressure. Secondary to Ventilatory ventilatory /ven·ti·la·to·ry/ (-lah-tor?e) pertaining to ventilation. ventilatory pertaining to or emanating from pulmonary ventilation. Pump Dysfunction
Page 6G-2
ICD-9-CM codes 518 and 786.9 were incorrectly worded.
They have been changed to:
518 Other diseases of lung
518.8 Other diseases of lung
786.9 Other symptoms involving respiratory
system and chest
Pattern H: Impaired Ventilation and respiration (Gas Exchange) With Potential for Respiratory Failure Respiratory Failure Definition Respiratory failure is nearly any condition that affects breathing function or the lungs themselves and can result in failure of the lungs to function properly. Page 6H-2 ICD-9-CM procedures code 54 was incorrectly worded. It has been changed to: 54 Other operations on abdominal region Pattern I: Impaired Ventilation and Respiration (Gas Exchange) With Mechanical Ventilation Secondary to Respiratory Failure
Page 6I-2
ICD-9-CM code 507.0 was incorrectly identified as 507
and has been changed to:
507.0 Due to inhalation of food or vomitus
Aspiration pneumonia
Integumentary integumentary /in·teg·u·men·ta·ry/ (in-teg?u-men´te-re) 1. pertaining to or composed of skin. 2. serving as a covering. integumentary 1. pertaining to or composed of skin. 2. Practice Patterns Pattern A: Primary Prevention/Risk Factor Reduction for Integumentary Disorders
Page 7A-3
Added to the ICD-9-CM codes:
995 Certain adverse effects not elsewhere
classified
Pattern C: Impaired Integumentary Integrity Secondary to Partial-Thickness Skin Involvement and Scar Formation Page 7C-3 ICD-9-CM code 943.2 was incorrectly worded. It has been changed to: 943.2 Blisters, epidermal loss[ second degree] Appendix Page Appendix 2-1 APTA's Standards of Practice for Physical Theraphy and the Criteria was updated to the version approved by the APTA Board of Directors in March 1997, which can be found in the January 1999 issue of the Journal. Numerical Index to ICD-9-CM Codes [Pneumonitis pneumonitis /pneu·mo·ni·tis/ (noo?mo-ni´tis) inflammation of the lung; see also pneumonia. hypersensitivity pneumonitis ] Due to inhalation inhalation /in·ha·la·tion/ (in?hah-la´shun) 1. the drawing of air or other substances into the lungs.inhala´tional 2. the drawing of an aerosolized drug into the lungs with the breath. 3. of food or vomitus vomitus /vom·i·tus/ (vom´i-tus) [L.] 1. vomiting. 2. matter vomited. vom·i·tus n. Vomited matter. vomitus 1. vomiting. 2. vomited material. was incorrectly identified as ICD-9-CM code 507 it has been changed to 507.0. ICD-9-Cm code 719.8 Other specified disorders of joint is now listed as appearing in the following patterns only: 4A, 4D, 4G, 4H, 4I. Alphabetical Index to ICD-9-CM Codes Atherosclerosis atherosclerosis (ăth'ərōsklərō`sĭs): see arteriosclerosis. atherosclerosis or hardening of the arteries (440) is now listed as appearing in the following patterns only: 6D, 6E, 7A, 7E. Burn of lower limb(s) (945) is now listed as appearing in the following patterns only: 6G, 7B, 7C, 7D The following codes have been deleted Deleted A security that is no longer included on a specified market. Sometimes referred to as "delisted". Notes: Reasons for delisting include violating regulations, failing to meet financial specifications set out by the stock exchange and going bankrupt. from Burn of lower limb(s) (945): Deep necrosis of uynderlying tissues [deep third degree] with loss of a body part (945.2) Deep necrosis of underlying tissues [deep third degree] without mention of loss of a body (945.4) Chronic airway obstruction chronic airway obstruction, n a persistent or recurring condition that impedes normal breathing. See also disease, chronic obstructive airways. , not elsewhere classified has been deleted. Complications of procedures, not elsewhere classified, other (998) is now listed as appearing in patterns 4D and (not 7F). [Pneumonitis] Due to inhalation of food or vomitus was incorrectly identified as ICD-9-CM code 507.1 and has been corrected to 507.0. Pulmonary embolism Pulmonary Embolism Definition Pulmonary embolism is an obstruction of a blood vessel in the lungs, usually due to a blood clot, which blocks a coronary artery. and infarction infarction, blockage of blood circulation to a localized area or organ of the body resulting in tissue death. Infarctions commonly occur in the spleen, kidney, lungs, brain, and heart. (415.1) is now listed as appearing in pattern 61 (not 6E). Rheumatoid arthritis rheumatoid arthritis Chronic, progressive autoimmune disease causing connective-tissue inflammation, mostly in synovial joints. It can occur at any age, is more common in women, and has an unpredictable course. and other inflammatory polyarthropathies (714) is now listed as appearing in the following patterns only: 4A, 4C, 4D, 41, 6B. If you use the Guide that was published in the November 1997 issue of Physical Therapy, the book version of the Guide that was published in 1997, the second printing (1998) of the Guide, or CD-ROM CD-ROM: see compact disc. CD-ROM in full compact disc read-only memory Type of computer storage medium that is read optically (e.g., by a laser). version 1998 of the Guide, please note the following changes (in shaded text): Some Important Global Changes "Represented and Reimbursed as Physical Therapy" In Part One of the Guide, the statement intended specifically for payers ("an examination, evaluation, or intervention-unless performed by a physical therapist or under the direction and supervision of a physical therapist--is not physical therapy, nor should it be represented or reimbursed as such") was clarified and expanded: Examination, evaluation, diagnosis, and prognosis are physical therapy--and should be represented and reimbursed as physical therapy--only when they are performed by a physical therapist. Intervention is physical therapy--and should be represented and reimbursed as physical therapy--only when performed by a physical therapist or under the direction, delegation, and supervision of a physical therapist. From "Desired Outcomes" to "Expected Outcomes" To emphasize that outcomes of patient/client management can and should be expected in a profession that is based in science, desired outcomes has been changed to expected outcomes. Discharge The definition of discharge has has been clarified: Discharged occurs at the end of an episode of care and is the end of physical therapy services that have been provided during that episode. The primary criterion for discharge: The anticipated goals and the expected outcomes have been achieved. In consultation with appropriate individuals, the physical therapist plans for discharge and provides for appropriate follow-up or referral. Discharge does not occur with transfer, that is, when a patient is moved from one site to another site within the same setting or across settings during a single episode of care; however, ther may be facility-specific or payer-specific requirements for documentation regarding the conclusion of physical therapy services as the patient moves between sites or across settings during that episode of care ... A new term, discontinuation dis·con·tin·u·a·tion n. A cessation; a discontinuance. Noun 1. discontinuation - the act of discontinuing or breaking off; an interruption (temporary or permanent) discontinuance of physical therapy services, has been added: Discontinuation of physical therapy services occurs when (1) the patient/client, caregiver, or legal guardian declines to continue intervention, (2) the patient/client is unable to continue to progress toward goals because of medical or psychosocial complications or because financial/insurance resources have been expended, or (3) the physical therapist determines that the patient/client will no longer benefit from physical therapy.... Tumor tumor: see neoplasm. versus Neoplasm neoplasm or tumor, tissue composed of cells that grow in an abnormal way. Normal tissue is growth-limited, i.e., cell reproduction is equal to cell death. Based on preferred usage in the current health care literature, neoplasm has replaced tumor in most instances. Other New or Revised Definitions Airway Clearance Techniques The definition of airway clearance techniques has been clarified to include: a broad group of activities used to manage or prevent consequences of acute and chronic lung diseases and impairment, including those associated with surgery. impaired mucociliary transport or impaired cough. Airway clearance techniques may be used with therapeutic exercise, manual therapy techniques, or mechanical modalities to improve airway protection, ventilation, and respiration. Episode of Care The definition of episode of care has been expanded: All patient/client management activities provided, directed, or supervised by the physical therapist, from initial contact through discharge. Episode of physical therapy care: Physical therapy services provided in an unbroken sequence and related to physical therapist intervention for a given condition or problem or related to a request from the patient/client, family, or other health care provider. May include transfers between sites within or across settings or reclassification of the patient/client diagnostic group. Reclassification may alter the expected range of number of visits and therefore may shorten or lengthen the episode of care. If reclassification involves a condition, problem, or request that is not related to the initial episode of care. a new episode of care may be initiated. Episode of physical therapy maintenance: A series of occasional clinical, educational, and administrative services related to maintenance of current function. Episode of physical therapy prevention: A series of occasional clinical, educational, and administrative services related to primary and secondary prevention, wellness, health promotion, and preservation of optimal function. Manual Therapy Techniques, Manipulation, and Mobilization mobilization Organization of a nation's armed forces for active military service in time of war or other national emergency. It includes recruiting and training, building military bases and training camps, and procuring and distributing weapons, ammunition, uniforms, The definitions of manual therapy techniques, manipulation, and mobilization have been clarified: Manipulation A skilled passive hand movement that usually is performed with a small amplitude at a high velocity at the end of the available range of motion. Manual Therapy Techniques A broad group of skilled hand movements, including but not limited to mobilization and manipulation, used by the physical therapist to mobilize or manipulate soft tissues and joints for the purpose of modulating pain; increasing range of motion; reducing or eliminating soil tissue swelling, inflammation, or restriction; inducing relaxation; improving contractile and noncontractile tissue extensibility; and improving pulmonary function. Mobilization A skilled passive hand movement at the end of the available range of motion that can be performed with variable speeds. Manipulation is one type of mobilization. Physical Therapist Assistant To be consistent with APTA policy (Direction, Delegation and Supervision in Physical Therapy Services, HOD 06-96-30-42), the definition has been changed: The physical therapist assistant is a technically educated health care provider who assists the physical therapist in the provision of physical therapy. The physical therapist assistant is a graduate of a physical therapist assistant associate degree program accredited by the Commission on Accreditation in Physical Therapy Education (CAPTE). Visit The following definition has been added: All encounters with a patient/client in a 24-hour period are summed as "one visit." Range of visits: All visits within a single episode of care. The range may be adjusted based on factors that may require a new episode of care or that may modify frequency of and duration of episode. The following items were defined within the Guide but were not included in the original Glossary A term used by Microsoft Word and adopted by other word processors for the list of shorthand, keyboard macros created by a particular user. See glossaries in this publication and The Computer Glossary. . They have been added to the Glossary as an aid to payers: Goals Goals generally relate to the remediation (to the extent possible) of impairments. Respiration Primarily, the exchange of oxygen and carbon dioxide across a membrane into and out of the lungs and at the cellular level. Ventilation The movement of a volume of gas into and out of the lungs. Musculoskeletal Practice Patterns Pattern 4C: Impaired Muscle Performance Page 4C-1 Upper and lower motor neuron lower motor neuron n. A motor neuron whose cell body is located in the brainstem or the spinal cord and whose axon innervates skeletal muscle fibers. Also called final motor neuron. disease has been deleted from the patient/client diagnostic group exclusions. Page 4C-2 Deleted from the ICD-9-CM codes: 781.0 Abnormal involuntary movements Pattern 4G: Impaired Joint Mobility, Motor Function, Muscle Performance, Range of Motion, or Reflex Integrity Secondary to Spinal Disorders Page 4G-2 Added to the ICD-9-CM codes: 724.3 Sciatica Neuromuscular neuromuscular /neu·ro·mus·cu·lar/ (-mus´ku-ler) pertaining to nerves and muscles, or to the relationship between them. neu·ro·mus·cu·lar adj. 1. Practice Patterns Pattern 5A: Impaired Motor Function and Sensory Integrity Associated With Congenital congenital /con·gen·i·tal/ (kon-jen´i-t'l) existing at, and usually before, birth; referring to conditions that are present at birth, regardless of their causation. con·gen·i·tal adj. 1. or Acquired Disorders An acquired disorder is a medical condition which develops post-fetally; in contrast with a congenital disorder, which is present at birth. A congenital disorder may be antecedent to an acquired disorder (such as Eisenmenger's syndrome). of the Central Nervous System in Infancy, Childhood, and Adolescence adolescence, time of life from onset of puberty to full adulthood. The exact period of adolescence, which varies from person to person, falls approximately between the ages 12 and 20 and encompasses both physiological and psychological changes. Page 5A-1 Nonprogressive neoplasm has been added to the list of patient/client diagnostic group inclusions. Progressive neoplasm has been added to the list of exclusions.
Page 5A-2
Deleted from the ICD-9-CM codes:
331 Other cerebral degenerations
331.3 Communicating hydrocephalus
331.4 Obstructive hydrocephalus
Added to the ICD-9-CM codes: 742.3 Congenital hydrocephalus hydrocephalus (hī'drəsĕf`ələs), also known as water on the brain, developmental (congenital) or acquired condition in which there is an abnormal accumulation of body fluids within the skull. Pattern B: Impaired Motor Function and Sensory Integrity Associated With Acquired Nonprogressive Disorders of the Central Nervous System in Adulthood Page 5B-1 Nonprogressive neoplasm and central vestibular ves·tib·u·lar adj. Of, relating to, or serving as a vestibule, especially of the ear. Vestibular Pertaining to the vestibule; regarding the vestibular nerve of the ear which is linked to the ability to hear sounds. disorders have been added to the list of patient/client diagnostic group inclusions. Progressive neoplasm has been added to the list of exclusions. Page 5B-2 Several ICD-9-CM codes have been added:
049 Other non-arthropod-borne viral diseases of the
central nervous system
049.9 Unspecified non-arthropod-borne viral
diseases of the central nervous system
Viral encephalitis, not otherwise specified
225 Benign neoplasm of brain and other parts of nervous
system
320 Bacterial meningitis
system
320.9 Meningitis due to unspecified bacterium
321 Meningitis due to other organisms
321.8 Meningititis due to other nonbacterial
organisms classified elsewhere
322 Meningitis of unspecified cause
322.9 Meningitis, unspecified
323 Encephalitis, myelitis, and encephalomyelitis
323.4 Other encephalitis due to intection classified
elsewhere
323.5 Encephalitis following immunization
procedures
323.6 Postintectious encephalitis
323.8 Other causes of encephalitis
323.9 Unspecified cause of encephalitis
331 Other cerebral degenerations
331.3 Communicating hydrocephalus
331.4 Obstructive hydrocephalus
342 Hemiplegia and hemiparesis
343 Infantile cerebral palsy
345 Epilepsy
345.1 Generalized convulsive epilepsy
345.2 Petit mal status
345.3 Grand mal status
345.4 Partial epilepsy, with impairment of
consciousness
Epilepsy: partial: secondarily generalized
345.5 Partial epilepsy, without mention of
impairment of consciousness
Epilepsy: sensory-induced
345.9 Epilepsy, unspecified
348 Other conditions of brain
348.0 Cerebral cysts
348.1 Anoxic brain damage
348.3 Encephalopathy, unspecified
386 Vertiginous syndromes and other disorders of
vestibular system
386.5 Labyrinthine dystunction
431 Intracerebral hemorrhage
433 Occlusion and stenosis of precerebral arteries
434 Occlusion of cerebral arteries
435 Transient cerebral ischemia
435.1 Vertebral artery syndrome
435.8 Other specified transient cerebral ischemias
436 Acute, but ill-defined, cerebrovascular disease
437 Other and ill-defined cerebrovascular disease
442 Other aneurysm
442.8 Of other specified artery
444 Arterial embolism and thrombosis
444.9 Of unspecified artery
447 Other disorders of arteries and arterioles
447.1 Stricture of artery
741 Spina bifida
742 Other congenital anomalies of nervous system
747 Other congenital anomalies of circulatory system
747.8 Other specified anomalies of circulatory
system
756 Other congenital musculoskeletal anomalies
756.1 Anomalies of spine
765 Discorders relating to short gestation and unspecified
low birthweight
767 Birth trauma
767.0 Subdural and cerebral hemorrhage
767.9 Birth trauma unspecified
768 Intrauterine hypoxia and birth asphyxia
768.5 Severe birth asphyxia
768.6 Mild or moderate birth asphyxia
768.9 Unspecified birth asphyxia in liveborn infant
771 Infections specific to the perinatal period
771.2 Other congenital infections
Congenital toxoplasmosis
780 General symptoms
780.3 Convulsions
781 Symptoms involving nervous and musculoskeletalsystems
781.2 Abnormality of gait
Gait: ataxic
781.3 Lack of coordination
Ataxia, not otherwise specified
799 Other ill-defined and unknown causes of morbidity
and mortality
799.0 Asphyxia
800 Fracture of vault of skull
801 Fracture of base of skull
803 Other and unqualified skull fractures
804 Multiple fractures involving skull or face with other bones
850 Consussion
851 Cerebral laceration and contusion
852 Subarachnoid, subdural, and extradural hemorrhage
following injury
853 Other and unspecified intracranial hemorrhagefollowing injury
854 Intracranial injury of other and unspecified nature
994 Effects of other external causes
994.1 Drowning and nonfatal submersion
Pattern 5C: Impaired Motor Function and Sensory Integrity Associated With Progressive Disorders of the Central Nervous System in Adulthood Page 5C- 1 Malignant malignant /ma·lig·nant/ (-nant) 1. tending to become worse and end in death. 2. having the properties of anaplasia, invasiveness, and metastasis; said of tumors. brain tumor Brain Tumor Definition A brain tumor is an abnormal growth of tissue in the brain. Unlike other tumors, brain tumors spread by local extension and rarely metastasize (spread) outside the brain. has been deleted from the list of patient/client diagnostic group inclusions. Progressive neoplasm has been added to the list of exclusions. Page 5C-2 Several ICD-9-CM codes have been added:
042 Human immunodeficiency virus (HIV) disease
191 Malignant neoplasm of brain
192 Malignant neoplasm of other and unspecified parts
of nervous system
237 Neoplasm of uncertain behavior of endocrine glands
and nervous system
237.5 Brain and spinal cord
331 Other cerebral degenerations
331.0 Alzheimer's disease
331.3 Communicating hydrocephalus
331.4 Obstructive hydrocephalus
332 Parkinson's disease
333 Other extrapyramidal disease and abnormal movement
disorders
333.0 Other degenerative diseases of the basal
ganglia
333.3 Tics of organic origin
333.4 Huntington's chorea
333.9 Other and unspecified extrapyramidal
disease and abdominal movement disorders
334 Spinocerebellar disease
334.2 Primary cerebellar degeneration
334.3 Other cerebellar ataxia
334.8 Other spinocerebellar diseases
335 Anterior horn cell disease
335.2 Motor neuron disease
335.20 Amyotrophic lateral sclerosis
340 Multiple sclerosis
341 Other demyelinating diseases of central nervous system
341.8 Other demyelinating diseases of central
nervous system
Central demyelination of corpus callosum
341.9 Demyelinating disease of central nervous
system, unspecified
345 Epilepsy
345.4 Partial epilepsy, with impairment of
consciousness
Epilepsy: partial: secondarily generalized
345.5 Partial epilepsy, without mention of
impairment of consciousness
Epilepsy: sensory-induced
348 Other conditions of brain
348.9 Unspecified condition of brain
780 General symptoms
780.3 Convulsions
781 Symptoms involving nervous and musculoskeletal
systems
781.2 Abnormality of gait
Gait: ataxic
781.3 Lack of coordination
Ataxia, not otherwise specified
Pattern 5D: Impaired Motor Function and Sensory Integrity Associated With Peripheral Nerve Injury There is no single classification system that can describe all the many variations of nerve injury. Most systems attempt to correlate the degree of injury with symptoms, pathology and prognosis. Page 5D-1 Peripheral vestibular disorders peripheral vestibular disorder Neurology A hallucination of movement, either subjective or objective History Duration of an attack–eg, hrs v. days, frequency daily v. (eg, labyrinthitis Labyrinthitis Definition Labyrinthitis is an inflammation of the inner ear that is often a complication of otitis media. It is caused by the spread of bacterial or viral infections from the head or respiratory tract into the inner ear. , parozysmal positional vertigo vertigo (vûr`tĭgō), sensations of moving in space or of objects moving about a person and the resultant difficulty in maintaining equilibrium. ) has been added to the list of patient/client diagnostic group inclusions. Page 5D-2 Several ICD-9-CM codes have been added:
225 Benign neoplasm of brain and other parts of nervous
system
225.1 Cranial nerves
350 Trigeminal nerve disorders
350.1 Trigeminal neuralgia
352 Disorders of other cranial nerves
352.4 Disorders of accessory (11 th) nerve
352.5 Disorders of hypoglossal (12th) nerve
352.9 Unspecified disorder of cranial nerves
353 Nerve root and plexus disorders
353.0 Brachial plexus lesions
353.1 Lumbosacral plexus lesions
353.6 Phantom limb (syndrome)
354 Mononeuritis of upper limb and mononeuritis multiplex
354.2 Lesion of ulnar nerve
354.3 Lesion of radial nerve
355 Mononeuritis of lower limb and unspecified site
357 Inflammatory and toxic neuropathy
357.1 Polyneuropathy in collagen vascular disease
386 Vertiginous syndromes and other disorders of the
vestibular system
386.0 Meniere's disease
386.03 Active Meniere's disease, vestibular
386.1 Other and unspecified peripheral vertigo
386.3 Labyrinthitis
Pattern 5E: Impaired Motor Function and Sensory Integrity Associated With Acute or Chronic Polyneuropathies
Page 5E-2
Added to the ICD-9-CM codes:
357.0 Acute infective polyneuritis
(Guillain-Barre syndrome)
Pattern 5F: Impaired Motor Function and Sensory Integrity Associated With Nonprogressive Disorders of the Spinal Cord spinal cord, the part of the nervous system occupying the hollow interior (vertebral canal) of the series of vertebrae that form the spinal column, technically known as the vertebral column.
Page 5F-2
Deleted from the ICD-9-CM codes:
192 Malignant neoplasm of other and
unspecified parts of nervous system
192.2 Spinal cord
Cauda eguina
198 Secondary malignant neoplasm of other
specified sites
198.3 Brain and spinal cord
Cardiopulmonary Practice Patterns Pattern 6H: Impaired Ventilation and Respiration (Gas Exchange) With Potential for Respiratory Failure
Page 6H-2
Deleted from the ICD-9-CM codes:
770 Other respiratory conditions of fetus and
newborn
770.7 Chronic respiratory disease arising
in the perinatal period
Bronchopulmonary dysplasia
Pattern 6I: Impaired Ventilation and Respiration (Gas Exchange) With Mechanical Ventilation Secondary to Respiratory Failure Page 6I-1 Immediate posttransplant (heart of lung or both), multisystem trauma, and sepsis Sepsis Definition Sepsis refers to a bacterial infection in the bloodstream or body tissues. This is a very broad term covering the presence of many types of microscopic disease-causing organisms. have been added to the list of patient/client diagnostic group inclusions.
Page 6I-2
Deleted from the ICD-9-CM codes:
770 Other respiratory conditions of fetus and
newborn
770.4 Primary atelactasis
770.7 Chronic respiratory diseases arising
in the perinatal period
Bronchopulmonary dysplasia
Integumentary Practice Patterns Pattern 7A: Primary Prevention/Risk Factor Reduction for Integumentary Disorders Page 7A-1 Break in skin integrity has been added to the list of patient/client diagnostic group exclusions. Page 7A-6 Total body surface area (TBSA TBSA Total Body Surface Area TBSA The Black Sword Alliance (gaming) TBSA TrailBike Sportsman Association ) of burn has been deleted from the list of "Factors That May Modify Frequency of Visits." Pattern B: Impaired Integumentary Integrity Secondary to Superficial Skin Involvement Page 7B-1 Any break in skin integrity has been deleted from the list of patient/client diagnostic group exclusions. Pattern 7E: Impaired Integumentary Integrity Secondary to Skin Involvement Extending Into Fascia fascia (făsh`ēə), fibrous tissue network located between the skin and the underlying structure of muscle and bone. Fascia is composed of two layers, a superficial layer and a deep layer. , Muscle, or Bone Page 7E-1 The title of this pattern has been corrected to "Impaired Integumentary Integrity Secondary to Skin Involvement Extending Into Fascia, Muscle, or Bone ans Scar Formation." Page 7F: Impaired Anthropometric an·thro·pom·e·try n. The study of human body measurement for use in anthropological classification and comparison. an Dimensions Secondary to Lymphatic System lymphatic system (lĭmfăt`ĭk), network of vessels carrying lymph, or tissue-cleansing fluid, from the tissues into the veins of the circulatory system. Disorders Page 7F-8 Under "specific direct interventions for "Physical Agents and Mechanical Modalities Modalities The factors and circumstances that cause a patient's symptoms to improve or worsen, including weather, time of day, effects of food, and similar factors. ," the following items have been deleted: Compression therapies Compression therapy may refer to:
Continuous passive motion continuous passive motion n. Abbr. CPM A technique in which a joint, usually the knee, is moved constantly in a mechanical splint to prevent stiffness and to increase the range of motion. (CPM (1) (Critical Path Method) A project management planning and control technique implemented on computers. The critical path is the series of activities and tasks in the project that have no built-in slack time. ) Appendixes Guidelines guidelines, n.pl a set of standards, criteria, or specifications to be used or followed in the performance of certain tasks. for Physical Therapy Documentation has been updated to the version approved by APTA's Board of Directors in November 1998. Guide for Professional Conduct has been updated to the version approved by APTA's Ethics and Judicial Committee in January 1999. These updated versions can be obtained through APTA's Service Center, 800/999-2782, ext 3395, or svcctr@apta.org. Numerical and Alphebetical Indexes to ICD-9-CM Codes All of the above changes have been reflected in the Indexes. In addition, the following corrections have been made: Enthesopathy of knee, unspesified 726.60.... 4F has been added. Viral encephalitis viral encephalitis Viral meningoencephalitis Neurology, infectious disease A general term for nonpurulent–'aseptic' viral infection of the CNS Etiology Coxsackie A and B–eg, A7, enterovirus 71, herpes simplex, etc Clinical If the viral load is extreme, is listed under Infectious and parasitic diseases A parasitic disease is an infectious disease caused or transmitted by a parasite. Many parasites do not cause disease per se. Parasitic diseases can affect practically all living organisms, from plants to man. The study of parasitic diseases is called by parasitology. , other and unspecified Adj. 1. unspecified - not stated explicitly or in detail; "threatened unspecified reprisals" specified - clearly and explicitly stated; "meals are at specified times" . |
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