ED Coding and Reimbursement Alert

Question: Can anyone tell me how they would code the following Fracture of the Dens. There was no spinal cord injury or mention of an open fracture. I'm not sure if I'm just looking in the wrong area. Thanks.

Answer: Dens is a protuberance at the axis or 2nd cervical vertebra. It exhibits a slight constriction or neck, where it joins the main body of the vertebra. The condition, where the Dens is separated from the body of the axis may cause nerve and circulation compression syndrome. There are three types of Dens- related fractures

• Type I Fracture - Extends through the tip of the dens. This type is usually stable.
• Type II Fracture - Extends through the base of the dens. It is the most commonly encountered fracture for this region of the axis. This type is never stable.
• Type III Fracture - Extends through the vertebral body of the axis. This type can be stable or unstable and may require surgery

ICD 9 code set 805 represents fractures of the vertebral column without mention of spinal injury. A fourth digit of "0" is used for closed fractures. Report.805.02 (Fracture of vertebral column without mention of spinal cord injury; Cervical, closed, second cervical vertebra) for a Dens fracture.