Official Disability Guidelines
ANKYLOSING SPONDYLITIS AND OTHER INFLAMMATORY SPONDYLOPATHIES
(3-digit ICD9 720)

DORSOPATHIES (720-724)
              Excludes:
              curvature of spine (737.0-737.9)
              osteochondrosis of spine (juvenile) (732.0) adult (732.8)

CM Triage: Level 3 (long term planning)

RTW Claims Data (Calendar-days away from work by decile)

10%20%30%40%50%60%70%80%90%100%Mean
121520253240497012036553.47

Impact on Total Absence: Prevalence 10.3730% of total lost workdays; Incidence 108.92 days per 100 workers

   Occupational Disability Durations, in days
   Median (mid-point)  27  -  Benchmark Indemnity Costs $20,250
                           Percent of Cases
                              (990 cases)
                                                                      
                                                               49.5   
                                                                      
                                                                      
                                                                      
                                                                      
                                                                      
                       16.2                                           
                                 12.1      11.1                       
                                                                      
    3.0       4.0                                     4.0             
  ______    ______    ______    ______    ______    ______    ______  
   1 day    2 days    3 to 5   6 to 10  11 to 20  21 to 30  31 or more
                           Range of Days

Impact on Occupational Absence: Prevalence 0.3032% of occupational lost workdays; Incidence 0.05 days per 100 workers

720  Ankylosing spondylitis and other inflammatory spondylopathies

Return-To-Work Summary Guidelines
DatasetMidrangeAt-Risk
Claims data15 days51 days
All absences14 days27 days

Return-To-Work "Best Practice" Guidelines
See 720.9

RTW Prescription: 720 New!
ICD-10 Code(s): M08.1, M45.0, M46, M48.9
ODG Treatment Contents: ODG/TWC Index
ODG Treatment UR Advisor: 720
Other Links: Click below for detailed information on this condition:
Merck Manual | Merck Home Edition | NGC | State Guidelines
Hospital Costs: $19,734 (average of 1,878 cases)
Hospital Length Of Stay: 5.7 days
Common Procedure Codes (see ODG Treatment for auto approval codes): 27096 72100 72110 72148 72170 76005 95904 97001 97002 97010 97014 97032 97035 97110 97112 97124 97140 97530 97750 98940 99202 99203 99204 99212 99213 99214 99243 99244 99282 99283 99284
CM Triage: Level 1 (low touch), inflection point 14 days

Workers' Comp Costs per Claim (based on 317 claims)
Quartile25%50%75%Mean% no cost
Indemnity$2,381$4,683$13,336$12,89255%
Medical$318$2,211$11,079$8,1653%
Total$431$3,561$14,878$14,1943%

720.0  Ankylosing spondylitis

Return-To-Work Summary Guidelines
DatasetMidrangeAt-Risk
Claims data21 days43 days
All absences14 days43 days

Return-To-Work "Best Practice" Guidelines
Clerical/modified work: 1 day
Manual work: 10 days
Heavy manual work, depending on progression: 21-42 days

Capabilities & Activity Modifications for Restricted Work:
Clerical/modified work: Lifting with knees (with a straight back, no stooping) not more than 5 lbs up to 3 times/hr; squatting up to 4 times/hr; standing or walking with a 5-minute break at least every 20 minutes; sitting with a 5-minute break every 30 minutes; no extremes of extension or flexion; no extremes of twisting; no climbing ladders; driving car only up to 2 hrs/day.
Manual work:  Lifting with knees (with a straight back) not more than 25 lbs up to 15 times/hr; squatting up to 16 times/hr; standing or walking with a 10-minute break at least every 1-2 hours; sitting with a 10-minute break every 1-2 hours; extremes of flexion or extension allowed up to 12 times/hr; extremes of twisting allowed up to 16 times/hr; climbing ladders allowed up to 25 rungs 6 times/hr; driving car or light truck up to a full work day; driving heavy truck up to 4 hrs/day.
RTW Prescription: 720.0 New!
Description: Chronic connective tissue disease causing inflammation of the spine and joints.  Back pain (often worse at night), stiffness which is often relieved by activity, pain in the hips, knees, and shoulders, and/or weight loss, fatigue, and a stopped or stiff posture are among the symptoms.
Other names: Marie-Strumpell arthritis
              Rheumatioid arthritis of spine NOS
              Spondylitis:
                Marie-Str
                rheumatoid
ICD-10 Code(s): M08.1, M45.0, M45.9
ODG Treatment Contents: ODG/TWC Index
Other Links: Click below for detailed information on this condition:
AHCPR Guideline | Merck Manual | Mayo Clinic | NGC | State Guidelines
Causality Likelihood: Under 5%
Hospital Costs: $29,711 (average of 703 cases)
Hospital Length Of Stay: 5.4 days
CM Triage: Level 1 (low touch), inflection point 14 days

RTW Claims Data (Calendar-days away from work by decile)

10%20%30%40%50%60%70%80%90%100%Mean
10111316212326414336527.55

   Integrated Disability Durations, in days*
   Median (mid-point)     14.0       Mean (average)        21.89
   Mode (most frequent)   1          Calculated rec.       13
                           Percent of Cases
                              (705 cases)
                                                                      
 16.2           15.0                                              15.6
                                                                      
                                                                      
                                                                      
                                     8.2                              
                      6.7       8.1                                   
            5.1                           5.4                         
                                                                      
       1.8                                                            
                           1.3                 1.1  0.1  0.1  0.0     
  ___  ___  ___  ___  ___  ___  ___  ___  ___  ___  ___  ___  ___  ___
    3    6    9   12   15   18   21   24   27   30   33   36   39  40+
                       Range of Days (up to)
   *CDC NHIS cases with no lost workdays: 107 (15.2%)

Impact on Total Absence: Prevalence 0.0269% of total lost workdays; Incidence 0.28 days per 100 workers

720.1  Spinal enthesopathy

Return-To-Work Summary Guidelines
DatasetMidrangeAt-Risk
Claims data15 days51 days
All absences14 days27 days

Return-To-Work "Best Practice" Guidelines
See 720.9

RTW Prescription: 720.1 New!
              Disorder of peripheral ligamentous or muscular attachments of spine
              Romanus lesion
ICD-10 Code: M46.0
Other Links: Click below for detailed information on this condition:
Merck Manual | Merck Home Edition | NGC
Hospital Costs: $14,686
CM Triage: Level 1 (low touch), inflection point 14 days
Impact on Total Absence: Prevalence 0.0002% of total lost workdays

720.2  Sacroiliitis, not elsewhere classified

Return-To-Work Summary Guidelines
DatasetMidrangeAt-Risk
Claims data19 days126 days
All absences5 days79 days

Return-To-Work "Best Practice" Guidelines
See 720.9

RTW Prescription: 720.2 New!
Description: Pain from inflammation within the joint at the juncture of the sacrum and the hip.
              Inflammation of sacroiliac joint NOS
ICD-10 Code: M46.1
ODG Treatment UR Advisor: 720.2
Other Links: Click below for detailed information on this condition:
Merck Manual | Merck Home Edition | NGC
Causality Likelihood: Zero
Hospital Costs: $12,861 (average of 1,037 cases)
Hospital Length Of Stay: 5.0 days
Common Procedure Codes (see ODG Treatment for auto approval codes): 27096 72100 72110 72148 72170 76005 97001 97010 97014 97032 97035 97110 97112 97124 97140 97530 97750 98940 99203 99204 99212 99213 99214 99243 99244 99282 99283
CM Triage: Level 3 (long term planning)

Workers' Comp Costs per Claim (based on 306 claims)
Quartile25%50%75%Mean% no cost
Indemnity$2,336$4,604$13,336$11,59955%
Medical$340$2,092$10,319$7,9994%
Total$454$3,442$13,710$13,4534%

RTW Claims Data (Calendar-days away from work by decile)

10%20%30%40%50%60%70%80%90%100%Mean
121314151933599112636550.99

   Integrated Disability Durations, in days*
   Median (mid-point)     5.5        Mean (average)        25.16
   Mode (most frequent)   1          Calculated rec.       9
                           Percent of Cases
                              (223 cases)
                                                                      
                                                                  29.6
                                                                      
                                                                      
                                                                      
                                                                      
 14.8                                                                 
                     10.3                                             
                                                                      
       5.4  4.0  5.8                                          3.6     
                           1.8  1.3  0.4  0.0  0.9  1.3  1.3          
  ___  ___  ___  ___  ___  ___  ___  ___  ___  ___  ___  ___  ___  ___
    1    2    3    4    5    6    7    8    9   10   11   12   13  14+
                               Days
   *CDC NHIS cases with no lost workdays: 43 (19.3%)

Impact on Total Absence: Prevalence 0.0093% of total lost workdays; Incidence 0.10 days per 100 workers

720.8  Other inflammatory spondylopathies

Return-To-Work Summary Guidelines
DatasetMidrangeAt-Risk
Claims data15 days51 days
All absences14 days27 days

Return-To-Work "Best Practice" Guidelines
See 720.9

RTW Prescription: 720.8 New!
ICD-10 Code(s): M46.8, M46.98, M49.8
Other Links: Click below for detailed information on this condition:
Merck Manual | Merck Home Edition | NGC
Hospital Length Of Stay: 1.0 days
CM Triage: Level 3 (long term planning)

720.81  Inflammatory spondylopathies in diseases classified elsewhere

Return-To-Work Summary Guidelines
DatasetMidrangeAt-Risk
Claims data15 days51 days
All absences14 days27 days

Return-To-Work "Best Practice" Guidelines
See 720.9

RTW Prescription: 720.81 New!
              Code also underlying disease, as:
                tuberculosis (015.0)
ICD-10 Code(s): M49.8, M49.80
Other Links: Click below for detailed information on this condition:
Merck Manual | Merck Home Edition | NGC
CM Triage: Level 3 (long term planning)

720.89  Other

Return-To-Work Summary Guidelines
DatasetMidrangeAt-Risk
Claims data15 days51 days
All absences14 days27 days

Return-To-Work "Best Practice" Guidelines
See 720.9

RTW Prescription: 720.89 New!
ICD-10 Code(s): M46.8, M46.80
Other Links: Click below for detailed information on this condition:
Merck Manual | Merck Home Edition | NGC
Hospital Costs: $11,854
Hospital Length Of Stay: 1.0 days
CM Triage: Level 3 (long term planning)

720.9  Unspecified inflammatory spondylopathy

Return-To-Work Summary Guidelines
DatasetMidrangeAt-Risk
Claims data15 days51 days
All absences14 days27 days

Return-To-Work "Best Practice" Guidelines
Asymptomatic: 0 days
Clerical/modified work: 5 days
Manual work: 14 days

RTW Prescription: 720.9 New!
Description: Inflammation of the joints between the vertebrae, which may or may not be infectious.  Symptoms include back pain, fatigue, morning stiffness that is relieved by activity, and low fever.
Other names: Infectious spondylitis, Noninfectious spondylitis
              Spondylitis NOS
ICD-10 Code(s): M46.5, M46.9, M48.9
ODG Treatment Contents: ODG/TWC Index
Other Links: Click below for detailed information on this condition:
AHCPR Guideline | Merck Manual | Mayo Clinic | NGC | State Guidelines
Causality Likelihood: Under 5%
Hospital Costs: $20,552 (average of 138 cases)
Hospital Length Of Stay: 5.7 days
CM Triage: Level 1 (low touch), inflection point 15 days

RTW Claims Data (Calendar-days away from work by decile)

10%20%30%40%50%60%70%80%90%100%Mean
13141414151616215118024.32

   Integrated Disability Durations, in days*
   Median (mid-point)     14.0       Mean (average)        16.48
   Mode (most frequent)   14         Calculated rec.       15
                           Percent of Cases
                              (109 cases)
                                                                      
                     30.3                                             
                                                                      
                                                                      
      18.3                                                            
                                                                      
 12.8                                                                 
                          10.1                                        
                                                                   6.4
                                                                      
            0.0  0.9            1.8  0.0  0.9  0.9  0.0  0.9  0.0     
  ___  ___  ___  ___  ___  ___  ___  ___  ___  ___  ___  ___  ___  ___
    3    6    9   12   15   18   21   24   27   30   33   36   39  40+
                       Range of Days (up to)
   *CDC NHIS cases with no lost workdays: 18 (16.5%)

Impact on Total Absence: Prevalence 0.0030% of total lost workdays; Incidence 0.03 days per 100 workers

ODG 2011 Work Loss Data Institute. All Rights Reserved.

CPT 2011 American Medical Association. All Rights Reserved.

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