lumbosacral Diagnostic Code Criteria /diagnostic Code Criteria / 5010 Arthritis, Due To Trauma, Substantiated By X-ray Findings Rate As Arthritis, Degenerative. D

[mjofdagame]

Can anyone tell me what this means in the simplest form please.This came in the mail today.

Diagnostic Code Criteria

/

5010 Arthritis, due to trauma, substantiated by X-ray findings

Rate as arthritis, degenerative.

Degenerative arthritis established by X-ray findings will be rated on the basis of limitation of motion under the appropriate diagnostic codes for the specific joint or joints involved (DC 5200 etc.). When however, the limitation of motion of the specific joint or joints involved is noncompensable under the appropriate diagnostic codes, a rating of 10 pet is for application for each such major joint or group of minor joints affected by limitation of motion, to be combined, not added under diagnostic code 5003. Limitation of motion must be objectively confirmed by findings such as swelling, muscle spasm, or satisfactory evidence of painful motion. In the absence of limitation of motion, rate as below:

With X-ray evidence of involvement of 2 or more major joints or 2 or more minor joint groups, with occasional incapacitating exacerbations...20

With X-ray evidence of involvement of 2 or more major joints or 2 or more minor joint groups...10

Note (1): The 20 pet and 10 pet ratings based on X-ray findings, above, will not be combined with ratings based on limitation of motion.

Note(2): The 20 pet and 10 pet ratings based on X-ray findings, above, will not be utilized in rating conditions listed under diagnostic code 5013 to 5024, inclusive.

§4.45 The joints

As regards the joints the factors of disability reside in reductions of their normal excursion of movements in different planes. Inquiry will be directed to these considerations:

(a) Less movement than normal (due to ankylosis, limitation or blocking, adhesions, tendon-tie-up, contracted scars, etc.).

( More movement than normal (from flail joint, resections, nonunion of fracture, relaxation of ligaments, etc.).

© Weakened movement (due to muscle injury, disease or injury of peripheral nerves, divided or lengthened tendons, etc.).

(d) Excess fatigability.

(e) Incoordination, impaired ability to execute skilled movements smoothly.

(f) Pain on movement, swelling, deformity or atrophy of disuse. Instability of station, disturbance of locomotion, interference with sitting, standing and weight-bearing are related considerations. For the purpose of rating disability from arthritis, the shoulder, elbow, wrist, hip, knee, and ankle are considered major joints; multiple involvements of the interphalangeal, metacarpal and carpal joints of the upper extremities, the interphalangeal, metatarsal and tarsal joints of the lower extremities, the cervical vertebrae, the dorsal vertebrae, and the lumbar vertebrae, are considered groups of minor joints, ratable on a parity with major joints. The lumbosacral articulation and both sacroiliac joints are considered to be a group of minor joints, ratable on disturbance of lumbar spine functions.

/

5010 Arthritis, due to trauma, substantiated by X-ray findings

Rate as arthritis, degenerative.

Degenerative arthritis established by X-ray findings will be rated on the basis of limitation of motion under the appropriate diagnostic codes for the specific joint or joints involved (DC 5200 etc.). When however, the limitation of motion of the specific joint or joints involved is noncompensable under the appropriate diagnostic codes, a rating of 10 pet is for application for each such major joint or group of minor joints affected by limitation of motion, to be combined, not added under diagnostic code 5003. Limitation of motion must be objectively confirmed by findings such as swelling, muscle spasm, or satisfactory evidence of painful motion. In the absence of limitation of motion, rate as below:

With X-ray evidence of involvement of 2 or more major joints or 2 or more minor joint groups, with occasional incapacitating exacerbations...20

With X-ray evidence of involvement of 2 or more major joints or 2 or more minor joint groups...10

Note (1): The 20 pet and 10 pet ratings based on X-ray findings, above, will not be combined with ratings based on limitation of motion.

Note(2): The 20 pet and 10 pet ratings based on X-ray findings, above, will not be utilized in rating conditions listed under diagnostic code 5013 to 5024, inclusive.

§4.45 The joints

As regards the joints the factors of disability reside in reductions of their normal excursion of movements in different planes. Inquiry will be directed to these considerations:

(a) Less movement than normal (due to ankylosis, limitation or blocking, adhesions, tendon-tie-up, contracted scars, etc.).

( More movement than normal (from flail joint, resections, nonunion of fracture, relaxation of ligaments, etc.).

© Weakened movement (due to muscle injury, disease or injury of peripheral nerves, divided or lengthened tendons, etc.).

(d) Excess fatigability.

(e) Incoordination, impaired ability to execute skilled movements smoothly.

(f) Pain on movement, swelling, deformity or atrophy of disuse. Instability of station, disturbance of locomotion, interference with sitting, standing and weight-bearing are related considerations. For the purpose of rating disability from arthritis, the shoulder, elbow, wrist, hip, knee, and ankle are considered major joints; multiple involvements of the interphalangeal, metacarpal and carpal joints of the upper extremities, the interphalangeal, metatarsal and tarsal joints of the lower extremities, the cervical vertebrae, the dorsal vertebrae, and the lumbar vertebrae, are considered groups of minor joints, ratable on a parity with major joints. The lumbosacral articulation and both sacroiliac joints are considered to be a group of minor joints, ratable on disturbance of lumbar spine functions.

[jbasser]

The only ones that can are the Organizations themselves. We can only complain but remember. It is the Buddy system.

Why was this system enacted?

To do exactly what it does today. Engineered so that complexity and confusion among the masses make it so difficult for anyone willing to challenge the system that very few will succeed.

The best we can do as advocates is to map the the complexity and confusion and show folks how to navigate it.

J

[Tbird]

everyone who comes here is a volunteer and since we have many many folks who come here to assist veterans or give them some support i hardly think that rates a "think of themselves only comment"

if you are so gun ho on helping veterans, then go ahead and help them and quit spending so much time complaining about the way the site is run. if you want to help individual veterans with their claims the best way to accomplish this goal is to give straight answers on the board.

tbird

we all are entitled to our beliefs. Its a shame most only think of themselves, when they claim they are here for others. I guess it helps them with their problems though.