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ICD-10 coding of pathological fracture

  • 02 Sep 2016 9:39 AM
    Reply # 4224251 on 4222948
    RHIA Administrator (Administrator)

    The first step would be to obtain a copy of the radiology report to confirm the exact location of the fracture.  Based on that information, look up that diagnosis with location in the alphabetical index.  There is a listing under Osteoporosis, age-related with current pathological fracture, pelvis M80.05-  When reviewing that diagnosis in the Tabular, pelvis is not listed.  The Official ICD-10-CM Coding Guidelines (B. General Coding Guidelines, 1.Locating a code in the ICD-10-CM)   “first locate the code in the Alphabetical index, and then verify in the Tabular List. Read and be guided by instructional notations that appear in both the Alphabetic Index and Tabular List.”  AHIMA coding training has been to always follow the direction of the Alphabetical Index even when not listed in the Tabular List. 


    Of note regarding M80.05-, in the Tabular List states “Age-related osteoporosis with current pathological fracture of the Femur/hip.”  Neither Femur or Hip were listed in the Alphabetical Index.  This issue underscores the need to review both the Alphabetical Index and Tabular List.

  • 01 Sep 2016 9:03 PM
    Message # 4222948
    Deleted user

    Diagnosis:  Age related osteoporosis with current pathological fracture, pelvis.

    Code sends us to fracture of hip.   Could someone please advise what code they would use.


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