BMUS: The Burden of Musculoskeletal Diseases in the United States
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Economic Cost ICD-9-CM Codes

X.L.0

Lead Author(s): 

Edward H. Yelin, PhD
Miriam Cisternas, MA

Supporting Author(s): 

Sylvia I. Watkins-Castillo, PhD

The ICD-9-CM codes used in the economic impact analysis by musculoskeletal diseases fall into the two categories of base codes and expansive codes.

Conditions included in the base musculoskeletal disease rubric include spine conditions, arthritis and joint pain, the category that includes osteoporosis (other diseases of bone and cartilage), injuries, and an inclusive “other” category for the remaining conditions. Conditions selected for the cost analysis presented are based on condition topics included in this site. Data are reported primarily for base case ICD-9-CM codes, or those codes for which musculoskeletal disease is the principal cause of the condition rather than a consequence of another major health condition (eg, bone cancer metastases from another primary cancer site).

Estimates are also provided for a more expansive list of codes of musculoskeletal-related diseases that include conditions for which musculoskeletal diseases are either the primary and secondary cause of the condition. This more expansive list of conditions yields a vastly larger prevalence estimate than the base case list. However, it is reasonable to assume the cost of musculoskeletal diseases probably exceeds the conservative estimates presented here. For example, a person with bone metastases would incur costs to treat the bone manifestation, even though the cancer, not the bone condition, is the primary etiology.

 ICD-9-CM codes included in each subcategory for the base and expansive conditions are listed in subsections.

Edition: 

  • 2014

Base Case ICD-9-CM Codes

S.L.1

Lead Author(s): 

Edward H. Yelin, PhD
Miriam Cisternas, MA

Supporting Author(s): 

Sylvia I. Watkins-Castillo, PhD

Spine        
    Special Symptoms or Syndromes, NEC : 307
    Migraine: 346
    Trigeminal Nerve Disorders : 350
    Nerve Root and Plexus Disorders : 353
    Dentofacial Anomalies, Including Malocclusion : 524
    Pain and Other Symptoms Associated with Female Genital Organs : 625
    Menopausal and Postmenopausal Disorders : 627
    General Symptoms : 780
    Symptoms Involving Skin and Other Integumentary Tissue : 782
    Symptoms Involving Head and Neck : 784
    Symptoms Involving Respiratory System and Other Chest Symptoms :    786
    Symptoms Involving Digestive System : 787
    Other Symptoms Involving Abdomen and Pelvis : 789
    Injury to Other Cranial Nerve(s) : 951
    Injury to Nerve Roots and Spinal Plexus : 953
Arthritis and Joint Pain        
    Gonococcal Infections : 098
    Other Venereal Diseases : 099
    Other and Unspecified Infectious and Parasitic Diseases : 136
    Other and Unspecified Disorders of Metabolism : 277
    Purpura and Other Hemorrhagic Conditions : 287
    Other Paralytic Syndromes : 344
    Mononeuritis of Upper Limb and Mononeuritis Multiplex : 354
    Inflammatory and Toxic Neuropathy : 357
    Other and Ill-defined Cerebrovascular Disease : 437
    Other Peripheral Vascular Disease : 443
    Polyarteritis Nodosa and Allied Conditions : 446
    Other Disorders of Arteries and Arterioles : 447
    Psoriasis and Similar Disorders : 696
Osteoporosis        
    Other Disorders of Bone and Cartilage : 733        
Musculoskeletal Injuries        
    Open Wound of Neck : 874
    Open Wound of Other and Unspecified Sites, Except Limbs : 879
    Contusion of Trunk : 922
    Contusion of Upper Limb : 923
    Contusion of Lower Limb and of Other and Unspecified Sites : 924
    Crushing Injury of Trunk : 926
Other Musculoskeletal Conditions        
    Other Salmonella Infections : 3
    Rat-bite Fever : 26
    Meningococcal Infection : 36
    Rubella : 56
    Other Arthropod-borne Diseases : 88
    Early Syphilis, Symptomatic : 91
    Other Forms of Late Syphilis, with Symptoms : 95
    Yaws : 102
    Late Effects of Tuberculosis : 137
    Malignant Neoplasm of Other and Ill-defined Sites : 195
    Secondary Malignant Neoplasm of Other Specified Sites : 198
    Other Malignant Neoplasms of Lymphoid and Histiocytic Tissue : 202
    Multiple Myeloma and Immunoproliferative Neoplasms : 203
    Other Benign Neoplasm of Connective and Other Soft Tissue : 215
    Neoplasm of Uncertain Behavior of Other and Unspecified Sites and Tissues : 238
    Neoplasms of Unspecified Nature : 239
    Disorders of Parathyroid Gland : 252
    Disorders of Lipoid Metabolism : 272
    Disorders of Mineral Metabolism :  275
    Hereditary Hemolytic Anemias : 282
    Organic Sleep Disorders : 327
    Mononeuritis of Lower Limb and Unspecified Site : 355
    Peritonitis and Retroperitoneal Infections : 567
    Other Cellulitis and Abscess : 682
    Other and Unspecified Congenital Anomalies : 759
    Late Effects of Injuries to Skin and Subcutaneous Tissues : 906
    Certain Early Complications of Trauma : 958
    Complications Peculiar to Certain Specified Procedures : 996
    Personal History of Other Diseases : V13
    Organ or Tissue Replaced By Transplant : V42
    Organ or Tissue Replaced By Other Means : V43
    Other Postprocedural States : V45
    Problems with Head, Neck, and Trunk : V48
    Fitting and Adjustment of Other Device : V53
    Convalescence and Palliative Care : V66
    Follow-up Examination : V67
    Special Screening Examination for Bacterial and Spirochetal Diseases : V74

Edition: 

  • 2014

Expansive Case ICD-9-CM Codes

X.L.2

Lead Author(s): 

Edward H. Yelin, PhD
Miriam Cisternas, MA

Supporting Author(s): 

Sylvia I. Watkins-Castillo, PhD

Spine        
    Special Symptoms or Syndromes, NEC : 307
    Migraine : 346
    Trigeminal Nerve Disorders : 350
    Nerve Root and Plexus Disorders : 353
    Dentofacial Anomalies, Including Malocclusion : 524
    Pain and Other Symptoms Associated with Female Genital Organs : 625
    Menopausal and Postmenopausal Disorders : 627
    General Symptoms : 780
    Symptoms Involving Skin and Other Integumentary Tissue : 782
    Symptoms Involving Head and Neck : 784
    Symptoms Involving Respiratory System and Other Chest Symptoms : 786
    Symptoms Involving Digestive System : 787
    Other Symptoms Involving Abdomen and Pelvis : 789
    Injury to Other Cranial Nerve(s) : 951
    Injury to Nerve Roots and Spinal Plexus : 953
Arthritis and Joint Pain        
    Gonococcal Infections : 098
    Other Venereal Diseases : 099
    Other and Unspecified Infectious and Parasitic Diseases : 136
    Other and Unspecified Disorders of Metabolism : 277
    Purpura and Other Hemorrhagic Conditions : 287
    Other Paralytic Syndromes : 344
    Mononeuritis of Upper Limb and Mononeuritis Multiplex : 354
    Inflammatory and Toxic Neuropathy : 357
    Other and Ill-defined Cerebrovascular Disease : 437
    Other Peripheral Vascular Disease : 443
    Polyarteritis Nodosa and Allied Conditions : 446
    Other Disorders of Arteries and Arterioles : 447
    Psoriasis and Similar Disorders : 696
Osteoporosis        
    Due to small sample sizes, no additional codes were included in the expansive analysis.       
Musculoskeletal Injuries        
    Open Wound of Neck : 874
    Open Wound of Other and Unspecified Sites, Except Limbs : 879
    Contusion of Trunk : 922
    Contusion of Upper Limb : 923
    Contusion of Lower Limb and of Other and Unspecified Sites : 924
    Crushing Injury of Trunk : 926
Other Musculoskeletal Conditions        
    Other Salmonella Infections : 3
    Rat-bite Fever : 26
    Meningococcal Infection : 36
    Rubella : 56
    Other Arthropod-borne Diseases : 88
    Early Syphilis, Symptomatic : 91
    Other Forms of Late Syphilis, with Symptoms : 95
    Yaws : 102
    Late Effects of Tuberculosis :  137
    Malignant Neoplasm of Other and Ill-defined Sites : 195
    Secondary Malignant Neoplasm of Other Specified Sites : 198
    Other Malignant Neoplasms of Lymphoid and Histiocytic Tissue : 202
    Multiple Myeloma and Immunoproliferative Neoplasms : 203
    Other Benign Neoplasm of Connective and Other Soft Tissue : 215
    Neoplasm of Uncertain Behavior of Other and Unspecified Sites and Tissues : 238
    Neoplasms of Unspecified Nature : 239
    Disorders of Parathyroid Gland : 252
    Disorders of Lipoid Metabolism : 272
    Disorders of Mineral Metabolism : 275
    Hereditary Hemolytic Anemias : 282
    Organic Sleep Disorders : 327
    Mononeuritis of Lower Limb and Unspecified Site : 355
    Peritonitis and Retroperitoneal Infections : 567
    Other Cellulitis and Abscess : 682
    Other and Unspecified Congenital Anomalies : 759
    Late Effects of Injuries to Skin and Subcutaneous Tissues : 906
    Certain Early Complications of Trauma : 958
    Complications Peculiar to Certain Specified Procedures : 996
    Personal History of Other Diseases : V13
    Organ or Tissue Replaced By Transplant : V42
    Organ or Tissue Replaced By Other Means : V43
    Other Postprocedural States : V45
    Problems with Head, Neck, and Trunk : V48
    Fitting and Adjustment of Other Device : V53
    Convalescence and Palliative Care : V66
    Follow-up Examination : V67
    Special Screening Examination for Bacterial and Spirochetal Diseases : V74

Edition: 

  • 2014
The Burden of Musculoskeletal Diseases in the United States - Copyright © 2014.

Source URL: https://bmus.latticegroup.com/2014-report/xl0/economic-cost-icd-9-cm-codes