Neurosurgery Coding Alert

Tip: Be specific about the cause and type of kyphosis. 

Kyphosis is a condition of excessive forward curvature of the spine, typically in the thoracic segments. Kyphosis is also known as roundback or Kelso’s hunchback. This causes the back to develop bowing and the patient has a slouching posture. You may look for one or more of these terms in the clinical note to be able to submit the diagnosis codes for kyphosis.

Is kyphosis physiological? There is a physiological convexity in the thoracic segment of the spine which typically ranges from 20° to 45°. When this curvature exceeds 45°, it is called hyperkyphosis.

“There is a condition called Schuermanb’s kyphosis that affects younger people, causing an exaggerated forward posture. This is in contrast to aging-related kyphosis that sometime affects the elderly,” says Gregory Przybylski, MD, director of neurosurgery at the New Jersey Neuroscience Institute, JFK Medical Center, Edison.

Check for Underlying Cause

When submitting a diagnosis of kyphosis, make sure you check what the underlying cause for kyphosis is. This will guide you to the most appropriate code in both ICD-9 and ICD-10.

What causes kyphosis? Kyphosis can be caused by a number of conditions. One of the causes for kyphosis is degeneration, for example, in arthritis. Osteopororsis, vertebral fractures, and vertebral trauma are other common causes for kyphosis. Kyphosis can be acquired due to a persistent bad posture. Kyphosis may occur as a consequence of surgical procedures in the spine, for example laminectomy or as a consequence of exposure to radiation.

Kyphosis may occur due to developmental problems. Scheuermann’s kyphosis is the most classic form of hyperkyphosis and is the result of wedged vertebrae that develop during adolescence. This is a developmental condition, and the cause for this condition is not precisely known. 

Kyphosis may occur due to other medical conditions, for example, tuberculosis of spine can cause a structural deformity and result in kyphosis. This is called Gibbus deformity.

“While this deformity is not commonly seen in the U.S. because of a low prevalence of TB, patients who have emigrated from countries where TB infection is endemic may present with this deformity here,” Przybylski says.

ICD-10 Offers Simple Codes

Later this year, when ICD-10 goes into effect, you will have specific and simple choices for diagnosis coding of kyphosis. You will find a one-to-one match for codes in ICD-10. 

The common ICD-9 and ICD-10 diagnosis codes for kyphosis are listed in table 1.