Forum - Questions & Answers

Aug 4th, 2011 - LGreen191

Pathological Fracture

An elderly patient with osteoporosis was admitted to acute care following a fall in which she sustained a T12 compression fracture. The physician clarified that this was a pathological fracture in a patient with bones weakened by osteoporosis. At the time of transfer from acute care she was still experiencing significant pain and plans were to proceed with kyphoplasty the following week. She was transferred from acute care to SNF, where she continued to receive hydrocodone and also received PT. Although surgical intervention (kyphoplasty) was planned at the time of transfer from acute to SNF, the insurance company denied this and surgery was not performed. In addition to V57.89, which code would be assigned for the SNF stay -- the code for the acute pathological fracture or that for aftercare of a healing pathological fracture?



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