Vertebral compression fractures

buckeye56

Networker
Messages
29
Best answers
0
ED coding, an elderly woman has a fall and one of the diagnoses is a vertebral compression fracture. Another diagnosis is back pain. The record does not specify whether or not this fracture relates to the fall or if it is traumatic or pathologic (x-ray report says that this is unknown). When I code, should I assume that it is traumatic or pathologic?
 
Last edited:

jdrueppel

Expert
Messages
435
Location
Lincoln, NE
Best answers
0
If the diagnosis is within E&M documentation of a trauma (i.e. the fall) I would code it as traumatic. This at least gives the payer the opportunity to investigate for third party liability.

Julie, CPC
 

buckeye56

Networker
Messages
29
Best answers
0
Thanks

Thanks for the replies. When I had a chance to discuss it with my supervisor she said she would code it as traumatic, since there was a fall.
 

cinnamon

Guest
Messages
25
Location
Las Vegas, NV
Best answers
0
ED coding, an elderly woman has a fall and one of the diagnoses is a vertebral compression fracture. Another diagnosis is back pain. The record does not specify whether or not this fracture relates to the fall or if it is traumatic or pathologic (x-ray report says that this is unknown). When I code, should I assume that it is traumatic or pathologic?


You don't code the back pain since you have the DX of vertebral compression fracture, possibly cause the back pain. Also Query the physician to find out how the fracture cause and whether traumatic or pathologic. Don't code just code anything. The physician would know and can give more details to help with the info in order for you to code properly.
 
Top