You may need any of the following, depending on how severe the fracture is:
In ICD-10-CM, codes for compression and pathologic fractures of the spine (not due to trauma) are located in Chapter 13, Diseases of the Musculoskeletal System and Connective Tissue. Category M48. 5-, Collapsed vertebra, not elsewhere classifiable is used for vertebrae fracture where no cause is listed.
Wedge compression fracture of fifth lumbar vertebra, initial encounter for closed fracture. S32. 050A is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. The 2022 edition of ICD-10-CM S32.
S32. 010A Wedge compression fracture of first lumbar vertebra, init - ICD-10-CM Diagnosis Codes.
In a compression fracture, the vertebral body collapses. The most common type of compression fracture is a wedge fracture, in which the front of the vertebral body collapses but the back does not, meaning that the bone assumes a wedge shape.
Wedge compression fracture of third lumbar vertebra, initial encounter for closed fracture. S32. 030A is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. The 2022 edition of ICD-10-CM S32.
03.
If you have no other documentation about the fracture (e.g. whether this is a pathological or a traumatic fracture), then this would code to category M48. 5 - Compression fracture of vertebra NOS, so I would use M48. 56XA for the lumbar site.
Wedge compression fracture of second lumbar vertebra, initial encounter for closed fracture. S32. 020A is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. The 2022 edition of ICD-10-CM S32.
Although all compression fractures have an underlying pathology, the term pathologic vertebral compression fracture (pVCF) is traditionally reserved for fractures that result from primary or metastatic spine tumors.
There are three types of compression fractures: wedge, crush, and burst.
Vertebral compression fractures (VCFs) occur when the bony block or vertebral body in the spine collapses, which can lead to severe pain, deformity and loss of height. These fractures more commonly occur in the thoracic spine (the middle portion of the spine), especially in the lower part.
There are many different types of spinal fractures: Compression, Burst, Flexion-distraction, and Fracture-dislocation. Each of these types of fractures are described. Other terms your doctor may use to describe a fracture include stable, unstable, minor, and/or major.
Wedge fracture — This fracture usually occurs in the front of the vertebra, collapsing the bone in the front of the spine and leaving the back of the same bone unchanged, which results in the vertebra taking on a wedge shape.
Although all compression fractures have an underlying pathology, the term pathologic vertebral compression fracture (pVCF) is traditionally reserved for fractures that result from primary or metastatic spine tumors.
Compression fractures are small breaks in the vertebrae (bones in your spine). They're more common in women over 50. As bones weaken with age and osteoporosis, they're more likely to break. Over time, breaks in the vertebrae cause the spine to collapse and curve over.
ICD-10 code M54. 5, low back pain, effective October 1, 2021. That means providers cannot use M54. 5 to specify a diagnosis on or after October 1—and existing patients with the M54. 5 diagnosis will need to be updated to a valid ICD-10 code.
Code to highest level of thoracic spinal cord injury. Injuries to the spinal cord ( S24.0 and S24.1) refer to the cord level and not bone level injury, and can affect nerve roots at and below the level given. Type 2 Excludes.
Fracture of thoracic vertebra 1 S22.0 should not be used for reimbursement purposes as there are multiple codes below it that contain a greater level of detail. 2 The 2021 edition of ICD-10-CM S22.0 became effective on October 1, 2020. 3 This is the American ICD-10-CM version of S22.0 - other international versions of ICD-10 S22.0 may differ.
injury of intrathoracic organ ( S27.-) open wound of abdomen, lower back and pelvis ( S31.-) Injuries to the spinal cord ( S34.0 and S34.1) refer to the cord level and not bone level injury, and can affect nerve roots at and below the level given.
S22.0 should not be used for reimbursement purposes as there are multiple codes below it that contain a greater level of detail.
whether this is a pathological or a traumatic fracture), then this would code to category M48.5 - Compression fracture of vertebra NOS, so I would use M48.56XA for the lumbar site.
I don't believe Medicare is covering the M48.5- code for Kyphoplasty anymore. You could use a M80.08X- or M80.88X- or the corresponding level code S32.0xxA code