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Ankylosing Spondylitis N005
In this section
Current RMA Instruments:
|Reasonable Hypothesis SOP||3 of 2013|
|Balance of Probabilities SOP||4 of 2013|
Changes from Previous Instruments:
- ICD-9-CM Codes: 720.0
- ICD-10-AM Codes: M45
This is a chronic progressive systemic inflammatory condition which mainly affects the spine (spondylitis), the costovertebral joints and sacroiliac joints leading to a fusion of the affected vertebrae (ankylosis). Since it affects the spine it is also called a spondyloarthropathy. See note below about other manifestations.
Is specific diagnostic evidence required to apply the SOP? – No.
The diagnosis is based on X-ray evidence as well as blood tests (ESR [Erythrocyte Sedimentation Rate], HLA B27). The appropriate medical specialist for this condition is a rheumatologist.
Are there sub-factors that require specific information? – No.
Additional diagnoses covered by SOP
- Marie-Strumpell disease
- Von Bechterew’s disease
Additional diagnoses which may be covered (further information required)
- HLA B27 spondyloarthropathy
- Inflammatory sacroilitis
- Sero-negative spondyloarthropathy
Conditions excluded from SOP
- Osteoarthritis or spondylosis of spine, ICD code 721.3
- Spondyloarthropathy – due to reactive arthritis (code 711.1); due to psoriatic arthritis (code 696.0); due to inflammatory bowel disease (code 555)
- Psoriatic spondylitis, ICD code 696.0
- Rheumatoid arthritis of the spine, code to 714.0
If, after considering the above information you are unable to apply the SOP, you should then:
- seek medical officer advice about further investigation, or;
- generate a diagnostic report, or;
- re-encode the condition, if appropriate.
The following investigations may be useful in establishing the diagnosis.
- report from treating specialist
- plain X-rays showing typical features can be diagnostic
Note: Other manifestations of ankylosing spondylitis
This systemic disease also may have other manifestations affecting:
- Other joints – peripheral asymmetric arthritis with synovitis.
- Enthesitis – inflammation of some tendon bone insertions.
- Eye changes – anterior uveitis
- Cardiac problems – aortic regurgitation; conduction abnormalities.
- Pulmonary changes – apical pulmonary fibrosis
There are also other complications arising from the spinal pathology such as spinal stenosis with radiculopathy and myelopathy; osteoporosis and spinal compression fractures.