# Code for compression fracture lumbar



## azeezchakravarthi (Feb 25, 2019)

Does anyone have any idea what diagnosis code should be used when a patient comes with *compression fracture of lumbar* for kyphoplasty procedure


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## thomas7331 (Feb 26, 2019)

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.


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## ashleighd (May 23, 2019)

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


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## ChattRiskCoder (Jun 18, 2019)

thomas7331 said:


> 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.


I agree with your coding @thomas7331  ; however, I was just recently dinged with the reasoning that you cannot index the compression fracture NOS code.


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## thomas7331 (Jun 18, 2019)

ChattRiskCoder said:


> I agree with your coding @thomas7331  ; however, I was just recently dinged with the reasoning that you cannot index the compression fracture NOS code.



I guess I could agree with that if they are strict with the guidelines, but then I don't think you can get to another code.  How did they say the diagnosis should have been coded then, or did they say you should have queried the provider?


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## ChattRiskCoder (Jun 18, 2019)

thomas7331 said:


> I guess I could agree with that if they are strict with the guidelines, but then I don't think you can get to another code.  How did they say the diagnosis should have been coded then, or did they say you should have queried the provider?


They said that the provider needs to document either pathological, traumatic/non-traumatic .  If you go to the M48.50XA, the tabular tells you that it is used for collapsed vertebra NOS.  Kind of frustrating.


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## ashleighd (Jun 18, 2019)

We do roughly 15 Kyphoplasties a month. If pathologic: M80.08xa or M80.88xa If traumatic: then S codes for the wedge compression type or you'd have to use the "Other Fracture type"


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