ICD 10 Codes Occupational Therapy 
JIA ICD 10
Juvenile Idiopathic Arthritis ICD 10 is used by occupational therapists for an autoimmune disorder that causes inflammation, pain, stiffness, and swollen joints in children under 16. It typically causes inflammation and joint pain in hands, knees, ankles, elbows and/or wrists, and can impact other body parts as well.
Symptoms for children with JIA can vary from minor to severe and can persist for a few months to years. JIA can affect child development and growth, vision, and joint damage. The exact cause of JIA is unknown, however, researchers believe that children with JIA have certain genes that are activated by a virus, bacteria or other external factors. There is no evidence that foods, toxins, allergies or lack of vitamins cause the disease.
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Diagnostic criteria
There are several different subtypes of JIA, which can be found below. Diagnosing JIA involves a series of tests, lab work, and/or imaging. A pediatrician may run a complete blood count panel, C-reactive protein, creatine, Rheumatoid factor, white blood cell count, genetic tests, and/or run X-rays, MRIs, or bone scans. If the eye is impacted, an ophthalmologist may run some tests as well.
1. Polyarticular JIA
- 5 or more joints are impacted
- May occur on both sides of the body/extremities including both small and larger joints
- Affects about 25% of children with JIA
2. Systemic JIA
- Joints, skin, and internal organs are impacted
- Includes a rash and 103-degree or higher fever that persists for 2 weeks.
- Affects about 10% of children with JIA
3. Oligoarthritis
- Most common type
- 1-4 joints are impacted
4. Psoriatic arthritis (PsA)
- Joint symptoms and a rash behind the ears and/or on the eyelids, elbows, knees, belly button, and scalp
- Skin symptoms may occur before or after joint symptoms appear
- May affect one or more joints, such as wrists, knees, ankles, fingers or toes
6. Enthesitis-related
- Also known as spondyloarthritis
- Entheses is where the bone is attached to the muscle, tendons, or ligaments
- Joints impacted: Hips, knees, and/or feet, fingers, elbows, pelvis, chest, and/or lower back vertebrae
- More common in boys and typically appears in children between the ages of eight and 15
7. Undifferentiated
Symptoms may not match up perfectly with any of the subtypes, but inflammation is present in one or more joints
Occupational therapy assessment for Juvenile Idiopathic Arthritis
Occupational therapists play a crucial role in the treatment of JIA, especially in helping children manage their pain, improve social participation, play skills, and overall physical function. Occupational therapists will evaluate strength, endurance, range of motion, swelling, pain, fine motor skills, gross motor skills, play skills, social skills, emotional regulation, and sensory preferences.
It is important to have a comprehensive picture of the child to gain a better understanding of how JIA impacts a child’s performance and participation in everyday life, specifically at home, school, and with peers. Based on the developmental stage and level of ability, therapists may administer JIA questionnaires.
Some JIA-specific questionnaires and assessments to better understand children with JIA include the following:
Juvenile Arthritis Functional Assessment Report (JAFAR)
- Assess the ability to perform physical tasks
- Age: 7-18 years
Juvenile Arthritis Quality of Life Questionnaire (JAQQ)
- Assesses motor skills, psychosocial function, general symptoms and level of pain
- Age 2-18 years
Juvenile Arthritis Functional Assessment Scale (JAFAS)
- Assesses ADLs considered important in children with JIA
- Age: 7-16 years
Juvenile Arthritis Functional Status Index (JASI)
- Functional ability assessment
- Age: 8-17 years
Juvenile Idiopathic Arthritis ICD 10
In occupational therapy, it is significantly important to document history, evaluation and assessment findings, goals, progress on goals, and communication amongst clients, caregivers, and other members of the healthcare team.
Using ICD-10 codes is a fundamental aspect of documentation. Currently, the ICD-10 database is still utilizing the term Juvenile Rheumatoid Arthritis. It is significantly important that therapists correctly document the proper subtype of JRA/JIA and use Juvenile Idiopathic Arthritis ICD 10 as it contributes to treatment planning, goal setting, and providing education.
The use of proper Juvenile Idiopathic Arthritis ICD 10 codes offer an improved ability to understand risk and severity. It is also vital to incorporate proper Juvenile Idiopathic Arthritis ICD 10 codes to ensure reimbursement, medical necessity, and continued care. In occupational therapy practice, the Juvenile Idiopathic Arthritis ICD 10 is a billable/specific code that can be used to indicate a diagnosis for reimbursement.
The following table has general Juvenile Idiopathic Arthritis ICD 10 codes. More specific codes with greater level of detail such as types of JRA/JIA and areas affected can be found on the ICD-10 database website.
It is important to utilize Juvenile Idiopathic Arthritis ICD 10 codes that are client-specific in occupational therapy practice as they improve the overall quality of care and management.
Juvenile Idiopathic Arthritis ICD 10 Code | Type |
---|---|
M08.00 | |
M08.419 | Pauciarticular juvenile rheumatoid arthritis, unspecified shoulder |
M08.229 | Juvenile rheumatoid arthritis w/ systemic onset, unspecified elbow |
M08.052 | Unspecified juvenile rheumatoid arthritis, left hip |
L40.51 | Distal interphalangeal psoriatic arthropathy |
*All Juvenile Idiopathic Arthritis ICD Codes from ICD10data.com
Pediatric intervention strategies
Intervention methods for JIA can involve a range of strategies depending on the level of severity and need of each client. It is important to remember that each child is unique and will have a different presentation of JIA and there is not a one-size fits all approach.
It is also important to have client-centered goals and treatment strategies to effectively manage and provide treatment for JIA. It is found that providing kids with age-appropriate physical movement focusing on improving strength and fitness, can positively impact their confidence, motivation, peer engagement, and overall quality of life.
Another component of exercise is to provide individualized range of motion (ROM) exercises that the child can do in daily activities to maintain joint mobility. These exercises may also be assigned as home programming. OTs may also create splints depending on the type, severity, and if necessary for the child. Splints may improve or maintain range of motion. They can help to reduce contractures. A hand splint also helps to reduce pain, swelling, or stress on the wrist or finger joints.
Treatment could also include adaptive aids or technology. The goal with adaptive aids is to minimize pressure on the joints and ideally shift the load to larger or more joints.
Examples of Adaptive aid can be found below.
- Adaptive eating utensils (e.g., thicker spoon handles)
- Dycem
- Elevated toilet seat
- Extended comb handles/long-handled bathing sponge
- Shoehorn
- Velcro on clothing and/or shoes
- Wheelchairs
- Writing aids
Therapists will also focus on fine motor skills, gross motor skills, and the ability to perform ADL tasks such as getting dressed or tying shoes, as well as participating in school-related tasks. Breaking down tasks into smaller, more manageable steps can help children feel more accomplished and successful.
Collaborating with school professionals to set up the environment to optimize learning and provide necessary physical, time, or accessibility-type accommodations is important. Another focus of therapy could be on social-emotional management. It is found that kids and teens with JIA are more likely to get depressed because they are living with a chronic disease. Having strong support can provide emotional support during tough times.
Treatment strategies for social-emotional regulation could be focused on emotional awareness, cognitive behavioral therapy, mindfulness, breath work, and/or meditation.
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Client-centered goals for Juvenile Idiopathic Arthritis
To promote motivation, active participation, and engagement in therapy, it is important to have meaningful and purposeful goals for treating JIA, as well as SMART goals. Focusing on client-centered goals that include the strengths, weaknesses, and unique attributes and preferences of the child will overall improve client outcomes.
One main component to consider during treatment and goal setting is the use of meaningful and motivating activities while also considering the developmental stage and ability of the client. It is also important to encourage self-advocacy by teaching clients to explain their wants, needs, and to provide opportunities for choices in order to have clients make appropriate decisions regarding their goals and therapy plan.
Providing education is another fundamental component of treatment planning and establishing goals. By equipping clients and caregivers with information, knowledge, support, and resources, caregivers and clients can become more empowered to manage and understand JIA. Therapists can also provide home programming, providing resources, connections for support groups, emotional-regulation strategies, and providing a comprehensive understanding of JIA. With a comprehensive and thorough approach, clients and caregivers can feel a sense of resiliency and self-empowerment, which overall contribute to positive client outcomes.
Overall, ensuring proper Juvenile Idiopathic Arthritis ICD code usage and documentation of JIA is essential due to the varying types and levels of severity. Proper documentation directly impacts treatment planning and establishing goals.
With appropriate Juvenile Idiopathic Arthritis ICD 10 coding, therapists have a better understanding of how to provide treatment modalities, manage restrictions and contraindications, if there are any, provide education to caregivers and clients, and monitor progress appropriately.
Appropriate Juvenile Idiopathic Arthritis ICD 10 coding, also contributes to adequate reimbursement, research, and interdisciplinary communication and collaboration. With adequate documentation, it overall contributes to improved client-centered care and positive outcomes for children with JIA.
Resources
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References
2024 ICD-10-CM diagnosis code M08.00: Unspecified juvenile rheumatoid. ICD-10-CM Codes. https://www.icd10data.com/ICD10CM/Codes/M00-M99/M05-M14/M08-/M08.00
Juvenile Idiopathic Arthritis (JIA): Arthritis foundation. Juvenile Idiopathic Arthritis (JIA) | Arthritis Foundation. https://www.arthritis.org/diseases/juvenile-idiopathic-arthritis
Oort, BSc, MSc, MScOT, CHT, C. V. (2020, August 25). Juvenile Idiopathic Arthritis and the OT role. http://OccupationalTherapy.com https://www.occupationaltherapy.com/articles/juvenile-idiopathic-arthritis-and-ot-5333
Understanding ICD-10. Johns Hopkins Medicine. https://www.hopkinsmedicine.org/johns-hopkins-health-plans/providers-physicians/icd-10
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