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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.
Wedge compression fracture of first lumbar vertebra, initial encounter for closed fracture
The ICD-10-CM is a catalog of diagnosis codes used by medical professionals for medical coding and reporting in health care settings. The Centers for Medicare and Medicaid Services (CMS) maintain the catalog in the U.S. releasing yearly updates.
A pathological fracture is classified to code 733.1x, with a fifth digit identifying the fracture site. Pathological fractures often occur in the vertebra (733.13), hip (733.14), and wrist (distal radius or Colles' fracture, 733.12).
A pathologic fracture is a break in a bone that is caused by an underlying disease. At the Spine Hospital at the Neurological Institute of New York, we specialize in pathologic fractures of vertebrae, or bones of the spine. For the most part, bones need a reason to break–for example, a significant trauma.
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).
A vertebral fracture may occur spontaneously and thus be more easily identified as occurring due to a disease (e.g. osteoporosis) and, therefore, coded as a pathologic fracture (ICD9 733.13).
A pathological fracture is one in which breaks in the bone were caused by an underlying disease. Examples of pathological fractures include those caused by cancer (see Figure 1), osteoporosis, or other bone diseases.
The femoral neck and head are the most common locations for pathologic fracture because of the propensity for metastases to involve proximal bones and because of the stress of weight placed on this part of the femur.
A break is called a pathologic fracture when force or impact didn't cause the break to happen. Instead, an underlying disease leaves your bones weak and brittle. You may move wrong or shift your body weight in a way that puts pressure on weak bones. For most people, it takes a significant force to break your bones.
Examples of traumatic fractures include fractures resulting from a fall, blunt injury or a motor vehicle accident1. There are several types of traumatic fractures, which include transverse, oblique, spiral, angulated and displaced fractures. A pathological fracture results from a break of a diseased or weakened bone.
Abstract. Whereas stress fractures occur in normal or metabolically weakened bones, pathologic fractures occur at the site of a bone tumor.
Consistent with current clinical experience, the fractures rated most likely due to osteoporosis were the femoral neck, pathologic fractures of the vertebrae, and lumbar and thoracic vertebral fractures. The fractures rated least likely due to osteoporosis were open proximal humerus fractures, skull, and facial bones.
The codes under M80 identify the site of the fracture. A code from category M80, not a traumatic fracture code, should be used for any patient with known osteoporosis who suffers a fracture – even if the patient had a minor fall or trauma – if that fall or trauma would not usually break a normal, healthy bone.
A pathological or fragility fracture is defined as a fracture sustained due to trauma no more severe than a fall from standing height, with the break occurring under circumstances that would not cause a fracture in a normal, healthy bone.
The seventh character “A” is for use as long as the patient is receiving active treatment for a pathologic fracture. Examples of active treatment include surgical treatment, emergency department encounters and evaluation and treatment by a new physician. The seventh character “D” is to be used for encounters occurring after the patient has completed active treatment. The other seventh characters, listed under each subcategory in the tabular list, are to be used for subsequent encounters for treatment of problems associated with healing, such as malunions, nonunions and sequelae. Care for complications of surgical treatment of fracture repairs, occurring during the healing or recovery phase, should be coded with the appropriate complication codes.
A code from category M80, not a traumatic fracture code, should be used for any patient with known osteoporosis who suffers a fracture – even if the patient had a minor fall or trauma – if that fall or trauma would not usually break a normal, healthy bone.