Deformity in children and adolescents was subdivided into five sections: upper extremity, lower extremity, hip and pelvis, spine, and other/unspecified.
Upper extremity deformity includes diagnoses such as polydactyly, syndactyly, reduction deformities such as amelia and longitudinal deficiencies of the upper extremity, and other congenital deformities such as synostosis, Madelung deformity, and Apert syndrome. A complete listing of deformity codes can be found by in the ICD-9-CM Child and Adolescents Codes [1].
Lower extremity deformity includes diagnoses such as polydactyly, syndactyly, reduction deformities such as amelia and longitudinal deficiencies of the lower extremity, genu varum, genu valgum, and other congenital developmental deformities such as clubfoot and flatfoot.
Hip and pelvis deformity includes diagnoses such as coxa valga, coxa vara, slipped capital femoral epiphysis, pelvic deformity, Legg Calves Perthes disease, and developmental dysplasia of the hip.
Spine deformity includes anomalies of the spinal cord such as syringomyelia and diastomatomyelia, as well as deformities of the vertebral column such as scoliosis, kyphosis, spondylolysis, spondylolisthesis, and congenital spinal anomalies.
Other and unspecified deformities include deformities of the chest wall such as pectus excavatum and pectus carinatum, as well as nonspecific deformity diagnoses.
Musculoskeletal deformities were diagnosed in 1.8 million children and adolescent health care visits in 2012, of which 943,800 had a primary diagnosis of musculoskeletal deformity. Among the total with any diagnoses of deformity, 111,800 children and adolescents were hospital discharges, with 30,100 hospitalizations for a primary diagnosis of a musculoskeletal infection. (Reference Table 7.1.1 PDF [2] CSV [3] and Table 7.1.2 PDF [4] CSV [5])
Females had a slightly higher rate of overall deformity diagnoses with hospitalization, and accounted for 55% of primary diagnosis hospitalizations. Children under the age of 1 year had a high rate of musculoskeletal deformity for any diagnosis with hospitalization (41%), but accounted for only 5% of primary hospitalizations. Primary diagnosis of musculoskeletal deformity with hospitalization increased with age.
Musculoskeletal deformity as a primary diagnosis accounted for 6% of hospitalizations for any musculoskeletal condition diagnosis, but only 0.5% of hospitalizations for any health care reasons for children and adolescents age 20 years and under. (Reference Table 7.3 PDF [6] CSV [7])
Deformity of the spine represented the largest share of hospitalizations (42%), followed by the lower extremity at 29% and upper extremity at 18%.
Total charges averaged $69,300 for a mean 6.4-day stay when children and adolescents were hospitalized with a diagnosis of musculoskeletal deformity along with other medical conditions. With a primary diagnosis of deformity, the stay was shorter (4.1 days), but mean charges were much higher at $94,500, primarily due to the higher charges for children and adolescents age 11 years and older. Total hospital charges for all primary musculoskeletal deformity discharges in 2012 were $2.84 billion. (Reference Table 7.3 PDF [6] CSV [7])
Links:
[1] http://www.boneandjointburden.org/2014-report/viig0/children-adolescent-icd-9-cm-codes
[2] https://bmus.latticegroup.com/docs/T7.1.1.pdf
[3] https://bmus.latticegroup.com/docs/T7.1.1.csv
[4] https://bmus.latticegroup.com/docs/T7.1.2.pdf
[5] https://bmus.latticegroup.com/docs/T7.1.2.csv
[6] https://bmus.latticegroup.com/docs/T7.3.pdf
[7] https://bmus.latticegroup.com/docs/T7.3.csv