2025 ICD-10-CM code A18.03
Tuberculosis of other bones. This includes tuberculous osteomyelitis and tuberculous mastoiditis.
Medical necessity for using A18.03 requires confirmation of tuberculosis affecting a bone other than the spine.This is established through diagnostic testing (positive cultures, biopsies) and clinical findings consistent with bone tuberculosis.
Clinicians diagnose and manage tuberculosis of the bone. This involves assessing patient history, conducting physical exams, ordering and interpreting diagnostic tests (tuberculin skin tests, imaging studies, biopsies), and prescribing appropriate treatment, including antituberculous medications and potentially surgical referral. They also monitor treatment response and manage potential complications.
In simple words: This code indicates tuberculosis that affects bones other than the spine, typically through an open wound or reactivation of a previous infection. It causes pain, swelling, and stiffness, and is diagnosed using skin tests, imaging, and bone samples. Treatment involves antibiotics and sometimes surgery.
Tuberculosis of other bones is a form of extrapulmonary tuberculosis that can occur through direct infection of the bone through an open wound, or reactivation of dormant Mycobacterium tuberculosis (and rarely Mycobacterium bovis) within the bone.This code is used when the specific bone affected is not represented by another code in the category. Symptoms include severe pain, tenderness, inflammation, and stiffness. Diagnosis is based on tuberculin skin tests, history of tuberculosis, imaging studies (MRI or CT), and confirmed by bone biopsy or abscess samples tested for acid-fast bacilli. Treatment typically involves antituberculous chemotherapy (isoniazid, rifampin, rifabutin, pyrazinamide, and ethambutol) and potentially surgical intervention in severe cases.
Example 1: A patient with a history of tuberculosis presents with persistent pain, swelling, and stiffness in the rib. Imaging reveals bone lesions consistent with tuberculosis. A bone biopsy confirms the presence of Mycobacterium tuberculosis, and the patient is diagnosed with tuberculosis of the rib, coded as A18.03., A patient sustains an open fracture of the femur in a farming accident. The wound becomes infected, and despite initial antibiotic treatment, the infection persists. Cultures reveal Mycobacterium bovis, leading to a diagnosis of tuberculosis of the femur, coded as A18.03., A patient with a history of treated tuberculosis develops mastoiditis. Cultures reveal Mycobacterium tuberculosis, confirming tuberculous mastoiditis. This is coded as A18.03.
Documentation should include evidence of tuberculosis infection (positive tuberculin skin test, history of TB, presence of acid-fast bacilli in bone tissue or abscess), imaging findings (MRI, CT), location of bone involvement, and clinical presentation (pain, swelling, stiffness).
- Specialties:Infectious Disease, Orthopedic Surgery, Radiology
- Place of Service:Inpatient Hospital, Outpatient Hospital, Physician's Office