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2025 ICD-10-CM code A18.02

Tuberculous arthritis of other joints. This condition involves pain, swelling, and limited movement in joints other than the spine.

Use additional code to identify resistance to antimicrobial drugs (Z16.-). Do not use A18.02 for spinal tuberculosis or other localized infections covered in other chapters.

Medical necessity for services related to A18.02 is established by confirming active tuberculous arthritis in a joint other than the spine. Documentation should support the diagnosis and treatment plan.

Physicians diagnose tuberculous arthritis based on tuberculin skin tests, patient history, and imaging studies like MRI or CT scans. Treatment involves antituberculous chemotherapy and potentially surgical intervention.

In simple words: Tuberculous arthritis is a type of tuberculosis that affects the joints, causing pain, swelling, and difficulty moving. It happens when tuberculosis bacteria spread from the lungs to the joints. Treatment usually involves antibiotics and sometimes surgery.

Tuberculous arthritis of other joints is a form of extrapulmonary tuberculosis affecting joints excluding the spine. It arises from direct bacterial introduction through wounds or reactivation of Mycobacterium tuberculosis (and rarely Mycobacterium bovis) lodged within the joint. Symptoms include pain, swelling, and limited range of motion. Diagnosis involves tuberculin skin tests, imaging (MRI/CT), and biopsy. Treatment comprises antituberculous chemotherapy (isoniazid, rifampin, rifabutin, pyrazinamide, ethambutol) and surgery in severe cases.

Example 1: A 35-year-old patient with a history of pulmonary tuberculosis presents with persistent knee pain, swelling, and reduced range of motion. Imaging reveals joint involvement, and A18.02 is used for diagnosis., A child with a recent history of an open wound on their elbow now experiences pain, swelling, and limited mobility. Tests confirm the presence of Mycobacterium tuberculosis in the joint, leading to a diagnosis of tuberculous arthritis using A18.02., An immunocompromised individual develops pain and swelling in their hip joint, along with fever and night sweats. Tests confirm tuberculous arthritis, excluding spinal involvement, thus A18.02 is applied.

Documentation should include evidence of Mycobacterium tuberculosis infection, joint involvement (excluding the spine), clinical findings such as pain, swelling, and reduced range of motion, imaging results, and biopsy findings (if performed).

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