CPT codes for Surgical and Non-surgical Treatment for Compression Fractures

Surgical and Non-surgical Treatment for Compression Fractures
English: A plain Xray of a person who has undergone vertebroplasty (Photo credit: Wikipedia)
Vertebral compression fractures are generally caused by trauma, weakening of vertebra or osteoporosis. Treatment for Compression fractures are done through Surgical and Non-surgical Techniques. Non-surgical procedure involves use of pain medication, which can relieve the acute or chronic pain due to collapsed fractured vertebra. Vertebra can be collaped due to decrease in bone density. Bone density is checked through DEXA scan. Surgical procedure involves percutaneous treatment for compression fractures through Vertebroplasty and Kyphoplasty. Now, we will learn all these procedures one by one. 

Non-surgical treatment of Compression fractures

Pain medications are very helpful for the treatment of compression fractures. Pain medication can relieve nerve, muscle or bone-to-bone pain. Antidepressant, non-steroidal anti-inflammatory drugs (NSAIDs) and Narcotic pain medication are few example of pain medication for treatment of compression fractures. Drugs, which help in increasing the density of bone or increasing the strength of bone, are also helpful in treating compression fracture. This is considering as critical part for the treatment of compression fracture. For acute pain, bed rest is best to keep the density of bone getting worse. Also checkout some basic procedure performed for finding a diagnosis in vertebra through Lumbar discogram and Lumbar Puncture procedure code.
In medical coding, the ICD 9 code for Compression fracture of Vertebra is 733.13

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ICD 10 codes for Compression fracture are detailed below:

M48.50XA: Collapsed vertebra, not elsewhere classified, site unspecified, initial encounter for fracture
M80.08XA: Age-related osteoporosis with current pathological fracture, vertebra(e), initial encounter for fracture
M84.48XA: Pathological fracture, other site, initial encounter for fracture
M84.68XA: Pathological fracture in other disease, other site, initial encounter for fracture

Surgical Treatment of Compression Fracture

The main treatment for Compression of Fracture is done through Vertebroplasy and kyphoplasty done percutaneously.

Vertebroplasty: It is a minimal invasive procedure performed by a one- or two-sided injection of a vertebral body. A patient is given local anesthesia before starting the procedure Using fluoroscopic guidance biopsy needle is placed into the collapsed vertebra. Sterile biomaterial such as methyl methacrylate is injected from one side or both sides into the damaged vertebral body and acts as a bone cement to reinforce the fractured or collapsed vertebra. The injected cement quickly gets hard and gives support to the structure of vertebra providing strength and stability. Following the procedure, the patient may experience significant, almost immediate pain relief.

The cpt codes used for Vertebroplasty for Treatment for Compression Fractures are detailed below:

First Vertebral body Thoracic spine- 22520
First Vertebral body Lumbar spine – 22521
Each additional thoracic or lumbar vertebral body- +22522 (add-on code)
These codes include a vertebral bone biopsy, if performed, during the same operative session.

Kyphoplasty: A modified percutaneous vertebroplasty is called as kyphoplasty. Kyphoplasty helps in treatment for Compression fractures by reducing the pain associated with osteoporotic vertebral compression fractures. The patient is placed in a prone, slightly flexed position. A 5 mm to 7 mm incision is made and small cannulas are inserted into the vertebral body from both sides. Balloon catheters, called "tamps," are inserted into the vertebra and inflated. The tamps create a void in the soft trabecular bone and restore vertebral alignment. The balloon is removed and bone cement is injected into the cavity.

The cpt codes used for Kyphoplasty for Treatment for Compression Fractures are detailed below:

First Vertebral body Thoracic – 22523
First Vertebral body Lumbar- 22524
Each additional Vertebral body thoracic or lumbar- +22525 (add-on code)

Hence, for the treatment for Compression fractures, we have many option to get rid of this disorder, but it will be good to get it treated it before it gets worse.

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