Wiki Compression Fracture- Initial or subsequent or Sequelae


Sumter, SC
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If an dr mentions that pt has osteoporosis with a compression fracture of the L-4 and L-5. Pt is on Boniva and goes to PT for chronic low back pain..... What is the correct code for the compression fx? The doctor doesn't seem to me as doing active txt.... This is not a healed old fx.
Guidelines state that if osteoporosis is documented with a fracture even if the fracture is due to minor trauma, you code it as a pathological fracture. As long as you know the trauma would not have fractured a healthy bone.
So in the absence of trauma documentation I would default this to an M80 for an osteoporotic fracture. And code it with the D for the 7th character. If the fracture is healed with chronic low back pain then the pain would be sequela.