Juvenile osteochondrosis of the left hip presenting as pseudocoxalgia — a condition in which avascular necrosis or osteochondrotic changes produce hip pain and a limp mimicking true hip joint disease, classified under the M91 chondropathy group.

Documentation tips

What should appear in the chart to support M91.32.

Source · Editorial brief grounded in 6 cited references ↓

• Explicitly state laterality as 'left hip' in every encounter note — this is required to justify M91.32 over the unspecified M91.30.
• Document the patient's age and skeletal maturity status; pseudocoxalgia under M91 is a juvenile osteochondrosis diagnosis and should align with a pediatric or adolescent patient.
• Record imaging findings (plain radiograph or MRI) that support osteochondrotic changes of the left proximal femur, including femoral head flattening, sclerosis, or fragmentation.
• Note symptom duration, gait pattern (antalgic limp), range-of-motion limitations, and any prior conservative treatment — these support medical necessity for imaging and specialist referral.
• If chondrolysis is also present, add M94.3 per the 'Use Additional Code' instruction at the M93.0 parent level when SUFE is excluded and chondrolysis is documented.

Related CPT procedures

Procedure codes commonly billed with M91.32. Linking the right diagnosis to the right procedure is what establishes medical necessity.

Source · CMS LCDs · AAOS specialty guidance · claims-pattern analysis

Common coding pitfalls

The recurring mistakes coders make with M91.32 and adjacent codes.

Source · Editorial brief grounded in CDC ICD-10-CM tabular guidance, AAOS coding references, and cited references ↓

• Coding M91.30 (unspecified hip) when the operative report or clinical note clearly names the left hip — always drill to M91.32 when laterality is documented.
• Confusing pseudocoxalgia (M91.3x) with Legg-Calvé-Perthes disease (M91.1x) — both are juvenile hip osteochondroses but represent distinct diagnoses with different clinical trajectories; use the code that matches the physician's stated diagnosis.
• Applying M91.32 to an adult patient without documented juvenile-onset history — this is a pediatric chondropathy code; adult hip avascular necrosis maps to M87.05x, not M91.
• Simultaneously assigning M91.32 and a slipped upper femoral epiphysis code (M93.0-) — the Type 1 Excludes at M91 prohibits coding these together; choose one based on the primary documented diagnosis.

Clinical context

Source · Editorial summary grounded in 6 cited references ↓

Sibling codes

Other billable codes under M91.3 (laterality / anatomic variants).