MDS item I0020B, the primary diagnosis is Z47.1 – Aftercare following joint replacement surgery and MDS item J2310: Hip replacement, partial or total, should be checked. Here are examples of the difference:Įxample 1 : A patient with severe degenerative osteoarthritis of the right hip, underwent right hip arthroplasty. For aftercare of a traumatic fracture, assign the acute fracture code with the appropriate 7th character. When is it appropriate to use the aftercare ICD-10 Z codes as the primary medical diagnosis in MDS item I0020B?Īccording to the CMS ICD-10-CM Official Guidelines for Coding and Reporting for Fiscal Year 2021, the aftercare Z codes should not be used for aftercare of traumatic fractures. Let us discuss the coding for major joint replacement conditions. It is important to communicate with the provider to ensure that necessary information is documented in the medical record within the assessment look-back period to identify the appropriate diagnosis codes. Records include the history and physical, recent hospital discharge summary, signed physician’s orders, provider consults, progress notes, and pertinent diagnostic reports. ![]() Understanding the International Classification of Diseases (ICD)-10 coding guidelines is one step figuring out the Centers for Medicare and Medicaid Services (CMS) PDPM ICD-10-CM Mappings Fiscal Year 2021 is another key element for the reimbursement calculation.Īssigning ICD-10 codes must be at the highest degree of specificity based on the provider-documented medical records. PMID 21637959.Under the Payment-Driven Payment Model (PDPM), the selection of the primary medical diagnosis recorded in the Minimum Data Set (MDS) item I0020B plays a factor in the Medicare Prospective Payment System (PPS) methodology. "Percutaneous vertebroplasty versus balloon kyphoplasty for treatment of osteoporotic vertebral compression fracture: A meta-analysis of randomised and non-randomised controlled trials". ^ Han, Shiliang Wan, Shuanglin Ning, Lei Tong, Yongjun Zhang, Jianfeng Fan, Shunwu (2011)."Balloon kyphoplasty and vertebroplasty in the management of vertebral compression fractures". "Balloon kyphoplasty in the management of vertebral compression fractures: An updated systematic review and meta-analysis". "Balloon Kyphoplasty and Vertebroplasty for Vertebral Compression Fractures". "Calcitonin for treating acute pain of osteoporotic vertebral compression fractures: A systematic review of randomized, controlled trials". ![]() ^ "Calcitonin for osteoporotic fractures".The Journal of the American Board of Family Medicine. "Kummel Disease: A Not-So-Rare Complication of Osteoporotic Vertebral Compression Fractures". Philadelphia: Lippincott Williams & Wilkins. Fundamentals of Diagnostic Radiology (3rd ed.). "Rounds 2: Treatment of Metastatic Bone Disease". When a tumor is suspected as the underlying cause, or the fracture was caused by severe trauma, CT or MRI scans may be performed. In addition, bone density measurement may be performed to evaluate for osteoporosis. ![]() Diagnosis Ĭompression fractures are usually diagnosed on spinal radiographs, where a wedge-shaped vertebra may be visible or there may be loss of height of the vertebra. Compression fractures which develop gradually, such as in osteoporosis, may initially not cause any symptoms, but will later often lead to back pain and loss of height. Signs and symptoms Īcute fractures will cause severe back pain. Seen in lateral views in plain x-ray films, compression fractures of the spine characteristically appear as wedge deformities, with greater loss of height anteriorly than posteriorly and intact pedicles in the anteroposterior view. ![]() In healthy patients, it is most often seen in individuals suffering extreme vertical shocks, such as ejecting from an ejection seat. This weakening is seen in patients with osteoporosis or osteogenesis imperfecta, lytic lesions from metastatic or primary tumors, or infection. It may be due to trauma or due to a weakening of the vertebra (compare with burst fracture). Example of vertebral compression fracture.Ī compression fracture is a collapse of a vertebra.
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