Wiki Chronic Osteoporosis Fractures


Tallahassee, FL
Best answers
My osteoporosis specialist will often treat patients who have what he calls "chronic vertebral fractures" caused by osteoporosis. These fractures frequently are very old, but still apparently causing the patient pain. The patient is coming in to receive a Prolia injection and I need an osteoporosis diagnosis code to be the primary code for the Prolia injection. Can I code this situation with M81.8, M54.5 and M8088XS, since the pain is a sequela of the fracture, even though the fracture is not technically current? Or would I just use the M80.88XS as the primary code just on the injection?
I believe the M80.88xs would be the best option here. There is no need for any other additional diagnoses such as pain, etc. Just make absolute certain that this is actually a diagnosed sequelae before using the 'S'.
It is my understanding that a sequela code cannot be used as the primary diagnosis. You have to list first the new problem (in this case pain) that is being caused by the old injury.