Home Health ICD-9/ICD-10 Alert

Question: How should we code a compression fracture of the spine the patient sustained when she fell? Would we use an aftercare code for acute traumatic fractures or would 733.13 for a pathologic fracture of vertebrae be more accurate?


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Answer: Compression fractures are usually considered pathological, so you would ordinarily use V54.27 (Aftercare for healing pathologic fracture of  vertebrae). However, in this case, the patient had a fall, so the fracture is traumatic and the correct aftercare code would be V54.17 (Aftercare for healing traumatic fracture of vertebrae). When a patient sustains such a fracture, rely on the physician's determination as to whether the fractures are pathological or traumatic.