Primer on ICD-10 Vertebral Fracture Coding

According to the American Academy of Orthopedic Surgeons, vertebral fractures are twice as common as other osteoporotic fractures in the wrist or hip. Every year, nearly 700,000 patients suffer from Osteoporotic vertebral fractures – and many of them might see your pain management physician for treatment before or after surgery.

Steps to Consider While Coding Fracture In ICD-10

Specifying the Cause of Fracture

In ICD-9, Pathological fracture for vertebrae was reported with single code 733.13, but that’s all going to change with commencement of ICD-10, because you specifically have to address the underlying cause of the fracture.

Here are some examples:

• ICD-10 code M80.08XA (Age-related osteoporosis with current pathological fracture, vertebra[e], initial encounter for fracture) can be used for reporting an osteoporotic vertebral fracture that occurs due to aging.
• ICD-10 code M80.88XA (Other osteoporosis with current pathological fracture, vertebra[e], initial encounter for fracture) can be used for reporting any other cause of the osteoporotic fracture such as endocrinological conditions or steroid use.
• ICD-10 code M84.58XA (Pathological fracture in neoplastic disease, other specified site, initial encounter for fracture) can be used for reporting fracture caused by neoplastic conditions such as Metastasis.

Specifying the Location

In ICD-10, while coding vertebral fracture, you have to specify the location of collapsed vertebra. Your physician might perform a Kyphoplasty to treat a patient with collapsed vertebra. In this case, you’ll report specific diagnosis codes depending upon the anatomical location of the fracture. For instance, the primary choices for an NOS type of code that doesn’t include specificity regarding causation will be:

• 52XA – Collapsed vertebra, not elsewhere classified, cervical region, initial encounter for fracture.
• 54XA – Collapsed vertebra, not elsewhere classified, thoracic region, initial encounter for fracture.
• 56XA – Collapsed vertebra, not elsewhere classified, lumbar region, initial encounter for fracture.

Specifying Junctions

In ICD-10, you even have specific diagnosis codes for vertebral fracture and collapse at the junction of two spinal regions.

For instance:

• M48.51XA (Collapsed vertebra, not elsewhere classified, occipito-atlanto-axial region, initial encounter for fracture) for collapse at the junction of the cervical region with the skull
• M48.53XA (Collapsed vertebra, not elsewhere classified, cervicothoracic region, initial encounter for fracture) for collapse at the junction of the cervical and thoracic region
• M48.55XA (Collapsed vertebra, not elsewhere classified, thoracolumbar region, initial encounter for fracture) for the collapse at the junction of the thoracic and lumbar regions
• M48.57XA (Collapsed vertebra, not elsewhere classified, lumbosacral region, initial encounter for fracture) for collapse at the junction of the lumbar and sacral regions.

Source: www.supercoder.com

 In ICD-10, it’s imperative to confirm the underlying cause and site before you pick the right code. Check out ProfEdOnDemand’s ICD-10 training program to learn the intricacies in ICD-10 coding.