Wiki Osteoporosis and Fracture guidelines

[daedolos]

EXAMPLE: Patient fell and broke right wrist. Patient has osteoporosis.


How would I code this? DO I code for the M osteopathic fracture as well as the S injury code for fracture?

Peace
@_*

 

[AlanPechacek]

Since the patient "fell," this would be a Traumatic Fracture, i.e. requiring an S Code from the S52.5 _ _ _ +/- S52.6 _ _ _ Code Sets, depending on the extent/severity of the fracture. The fact that the patient has Osteoporosis is not relevant to the fact that she fell. If she has "documented" Osteoporosis, it could be listed as a complementary/supplemental code from the M81 Code Set, which is the Code Set for the Disease of Osteoporosis. External Cause Codes may or may not be required by her insurance/payer.

I refer you to icd10orthocoder.com where you can review the Blog on Fractures of the Forearm and Wrist, and External Cause Coding if required.

Respectfully submitted, Alan Pechacek, M.D.
icd10orthocoder.com

 

[daedolos]

SO I can use both S and M codes?

Peace
?_?
Thank you for your response.

 

[mitchellde]

you can use the S code for the fracture and the M code for the osteoporosis without pathologic fracture.
However if it is by chance documented that the fall was minor and would not have fractured a healthy bone then follow coding guidelines that state:
A code from category M80, not a traumatic fracture code, should be used for any patient with known osteoporosis who suffers a fracture, even if the patient had a minor fall or trauma, if that fall or trauma would not usually break a normal, healthy bone.

 

[daedolos]

Thank you for that clarification.

Peace
@_*