Wiki Code for compression fracture lumbar

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