Comparison/Contrast of Compression Fracture coding in both ICD-9 CM/ICD-10 CM.

1. COMPRESSION FRACTURE
Discussion: Although, the alphabetical index for ICD-9 CM does not include the descriptive
term traumatic after the main term Fracture as it does in ICD-10 CM, the coder can make the
assumption that “compression fractures” are considered traumatic. This assumption would lead
the coder to code traumatic “compression fractures”, if the documentation supports the same, by
site. In ICD-10 CM there are no instructions relating to a traumatic compression fracture. Are
we to code traumatic compression fractures by site as well? The subterm compression does fall
under the main term Fracture, Traumatic. Next, if we continue to follow the dictates of the
alphabetical index for both nomenclatures we find that in ICD-10 CM nontraumatic
compression fractures are considered to be of the vertebrae (collapse) only and the coder is led to
“see collapse vertebrae” in the index. However, in ICD-9 CM nontraumatic compression
fractures are considered pathological. Once the coder follows the instructions to “see Fracture,
Pathological”; it is further noted that pathological fractures include ankle, femur fibula, hip,
humerus, radius, tibia, ulna, vertebrae (collapse), wrist and specified site. It would seem that
accuracy in coding compression fractures in ICD-10 CM will depend heavily on documenting
whether the fracture is a traumatic or nontraumatic compression fracture AND by further
clarifying whether or not compression fractures should be coded by site.
Cynthia Brown, MBA, RHIT, CCS
AHIMA Approved ICD-10 CM/PCS Trainer
CyntCoding Health Information Services
Phone: 404-992-8984/E-Fax: 678-805-4919
P.O. Box 3019
Decatur, GA 30031
cyntcoder@cyntcodinghealthinformationservices.com
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Coding Yesterday’s Nomenclature Today®
COMPRESSION FRACTURE
CODING
COMPARISON/CONTRAST
IN ICD-9 CM/ICD-10 CM
In the ICD-9 CM
ALPHABETICAL INDEX Find
Fracture; then subterm
Compression
You are instructed to See
also Fracture by Site
assuming the Fracture is of
a Traumatic Nature
If Fracture is Nontraumatic;
you are intructed to see
Fracture, Pathological
In ICD-10 CM
ALPHABETICAL INDEX Find
Fracture, Tramumatic; then
subterm Compression
If Fracture is not due to
trauma; you are instructed
to see Collapse, Vertebrae

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