Wiki Vertebral Compression Fracture

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opmramirez71@gmail.com

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I need help, I personally don't believe there is a code to treat a vertebral body compression fracture conservatively.

Below is what the medical staff wrote to me:
"When we are treating a vertebral body compression fracture conservatively with a brace, there is a CPT code we need to use to indicate that...And, is it supposed to be used for three months during the fracture care timeframe"

basically pt had surgery 7 weeks ago, came in for ofc visit, already wearing a TLSO, but pt went on a cruise, fell and now fractured in a different area. Pt is status post L4-L5 now has compression fracture L1 from fall....
basically just manipulated TLSO in office visit...no treatment in my opinion. Pt had TLSO so that was used for this as well
 
MRAMIREZ@TIFS.ORG said:
I need help, I personally don't believe there is a code to treat a vertebral body compression fracture conservatively.

Below is what the medical staff wrote to me:
"When we are treating a vertebral body compression fracture conservatively with a brace, there is a CPT code we need to use to indicate that...And, is it supposed to be used for three months during the fracture care timeframe"

basically pt had surgery 7 weeks ago, came in for ofc visit, already wearing a TLSO, but pt went on a cruise, fell and now fractured in a different area. Pt is status post L4-L5 now has compression fracture L1 from fall....
basically just manipulated TLSO in office visit...no treatment in my opinion. Pt had TLSO so that was used for this as well
Click to expand...

22305-22315 maybe ? 22315 is closed treatment with bracing, by manipulation or traction...sounds like that might fit. :confused:
 
Our office will report the 22315 (based on in this scenario) with a modifier 79 for a different injury in a different vertebrae and then with a modifier 54, surgical care only. This removes the preop and postop payment, but the provider does recoup payment for some of his work.

This is what our Compliance team and Coding Manager and Board determined was ethical and patient friendly.
 
CPT 22315: "Closed treatment of vertebral fracture(s) and/or dislocation(s) requiring casting or bracing, with and including casting and/or bracing by manipulation or traction Physicians perform this procedure to treat vertebral fractures or dislocations, which often result from stress injuries or trauma." The AAPC Coder notes in layman's terms:
"The surgeon administers anesthesia and manipulates the patient's spine to reduce the fracture into the appropriate position. He applies a brace, cervical collar, or other immobilization device to hold the patient's fracture in a stable position."
 
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