You would code the aftercare codes for follow up visits while the fracture is healing after the initial treatment. The guidelines state: "Fractures are coded using the aftercare codes for encounters after the patient has completed active treatment of the fracture and is receiving routine care for the fracture during the healing or recovery phase.
Fracture Codes . Assign separate codes for each fracture unless there is a combination code. When multiple fractures or injuries occur at the same time, the provider determines the diagnosis for the most serious fracture/injury and the focus of treatment (sequenced first). Also, assign the appropriate 7. th. character (see below for descriptions).
Treat Spinal Compression Fractures Without Surgery
A T12 or L1 compression fracture most commonly happens as a wedge fracture, which occurs when the front part of the vertebra collapses and the back doesn't, making the bone look like a wedge. Osteoporosis, which causes decreased bone density, is a common risk factor for compression fractures.
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.
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.
Compression fractures of the spine usually occur at the bottom part of the thoracic spine (T11 and T12) and the first vertebra of the lumbar spine (L1). Compression fractures of the spine generally occur from too much pressure on the vertebral body.
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.
ICD-10-CM Code for Wedge compression fracture of unspecified thoracic vertebra, initial encounter for closed fracture S22. 000A.
ICD-10-CM Code for Wedge compression fracture of first lumbar vertebra, initial encounter for closed fracture S32. 010A.
03.
Pathological spine fractures are the result of an underlying disease process that affects the spine. They are called vertebral compression fractures and are common, and frequent in the elderly. They may be caused by osteoporosis, Paget's disease, other diseases and spinal infections (osteomyelitis).
twelfth thoracic vertebraThe T12, or twelfth thoracic vertebra is the largest of all your thoracic vertebrae, and is the lowermost in the back. It's designed to bear the weight of your spine, and is the strongest of all vertebrae in the region, but it's also the most prone to injuries from stress.
The T12 vertebra sits right above the lumbar spinal column. It is the largest and most inferior of the thoracic spinal vertebrae. The T12 vertebrae location is between the T11 vertebra and the first lumbar vertebra, L1, in the trunk region.
A compression fracture is a type of broken bone that can cause your vertebrae to collapse, making them shorter. This often happens to the front of the vertebrae but not the back, causing you to stoop forward over time.