ICD-10 Coding for Vertebral Compression Fracture(M80.08XA, S22.080A)
Complete ICD-10-CM coding and documentation guide for Vertebral Compression Fracture. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Vertebral Compression Fracture
M80-M84Primary Range
Disorders of bone density and structure
Includes osteoporosis with current pathological fracture, which is common in vertebral compression fractures.
Fracture of rib(s), sternum and thoracic spine
Covers traumatic fractures of the thoracic spine, relevant for high-impact injuries.
Other spondylopathies
Includes collapsed vertebra not elsewhere classified, used when the cause is undetermined.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| M80.08XA | Osteoporosis with current pathological fracture, vertebra, initial encounter | Use when a vertebral fracture is due to osteoporosis and confirmed by imaging. |
|
| S22.080A | Fracture of T8 vertebra, initial encounter for closed fracture | Use for vertebral fractures resulting from significant trauma. |
|
Clinical Decision Support
Always review the patient's clinical documentation thoroughly. When in doubt, choose the more specific code and ensure documentation supports it.
Key Information: ICD-10 code for vertebral compression fracture
Essential facts and insights about Vertebral Compression Fracture
Primary ICD-10-CM Codes for vertebral compression fracture
Decision Criteria
clinical Criteria
- Presence of osteoporosis with vertebral fracture
documentation Criteria
- Imaging confirmation of fracture and osteoporosis
Applicable To
- Osteoporotic vertebral fracture
Excludes
- Traumatic vertebral fracture (S22.0-)
Clinical Validation Requirements
- DEXA scan showing T-score ≤-2.5
- MRI showing bone marrow edema
Code-Specific Risks
- Incorrect use without osteoporosis confirmation
Coding Notes
- Ensure osteoporosis is documented with imaging and clinical findings.
S22.080A - Fracture of T8 vertebra, initial encounter for closed fracture
Use for vertebral fractures resulting from significant trauma.
Applicable To
- Traumatic vertebral fracture
Excludes
- Pathological fracture due to osteoporosis (M80.08XA)
Clinical Validation Requirements
- CT scan showing fracture from trauma
- Documented high-impact injury
Coding Notes
Ensure trauma is documented as the cause of the fracture.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Personal history of (healed) osteoporosis fracture
Z87.310Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Vertebral Compression Fracture to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code M80.08XA.
Impact
Clinical: Mismanagement of patient treatment plans., Regulatory: Non-compliance with coding standards., Financial: Potential claim denials.
Mitigation Strategy
Ensure detailed documentation of injury mechanism., Confirm underlying conditions with imaging.
Impact
Reimbursement: Incorrect coding can lead to denied claims., Compliance: Non-compliance with ICD-10 coding guidelines., Data Quality: Inaccurate data on osteoporosis-related fractures.
Mitigation Strategy
Use M80.08XA when osteoporosis is the underlying cause.
Impact
Inadequate documentation of fracture cause can lead to audit issues.
Mitigation Strategy
Ensure thorough documentation of injury mechanism and underlying conditions.
Documentation errors, coding pitfalls, and audit risks are interconnected aspects of medical coding and billing. Addressing all three areas helps ensure accurate coding, optimal reimbursement, and regulatory compliance.
Frequently Asked Questions
Common questions about ICD-10 coding for Vertebral Compression Fracture, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Vertebral Compression Fracture
Use these documentation templates to ensure complete and accurate documentation for Vertebral Compression Fracture. These templates include all required elements for proper coding and billing.
Acute osteoporotic vertebral fracture
Specialty: OrthopedicsRequired Elements
- Fracture site and type
- Osteoporosis confirmation
- Imaging findings
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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