Local Coverage Article Billing and Coding

Billing and Coding: Bone Mineral Density Studies

A56484

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Article Information

General Information

Article ID
A56484
Article Title
Billing and Coding: Bone Mineral Density Studies
Article Type
Billing and Coding
Original Effective Date
01/08/2019
Revision Effective Date
03/24/2020
Revision Ending Date
N/A
Retirement Date
N/A
AMA CPT / ADA CDT / AHA NUBC Copyright Statement

CPT codes, descriptions and other data only are copyright 2021 American Medical Association. All Rights Reserved. Applicable FARS/HHSARS apply.

Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT, and the AMA is not recommending their use. The AMA does not directly or indirectly practice medicine or dispense medical services. The AMA assumes no liability for data contained or not contained herein.

Current Dental Terminology © 2021 American Dental Association. All rights reserved.

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CMS National Coverage Policy

N/A

Article Guidance

Article Text

This First Coast Billing and Coding Article for Local Coverage Determination (LCD) L36356 Bone Mineral Density Studies provides billing and coding guidance for frequency limitations as well as diagnosis limitations that support diagnosis to procedure code automated denials. However, services performed for any given diagnosis must meet all of the indications and limitations stated in the LCD, the general requirements for medical necessity as stated in CMS payment policy manuals, any and all existing CMS national coverage determinations, and all Medicare payment rules.

Refer to the LCD for reasonable and necessary requirements and limitations.

The redetermination process may be utilized for consideration of services performed outside of the reasonable and necessary requirements in the LCD.

Coding Guidelines

Notice: It is not appropriate to bill Medicare for services that are not covered (as described by this entire LCD) as if they are covered. When billing for non-covered services, use the appropriate modifier.

Documentation Requirements

  1. All documentation must be maintained in the patient's medical record and made available to the contractor upon request.
  2. Every page of the record must be legible and include appropriate patient identification information (e.g., complete name, dates of service[s]). The documentation must include the legible signature of the physician or non-physician practitioner responsible for and providing the care to the patient.
  3. The submitted medical record must support the use of the selected ICD-10-CM code(s). The submitted CPT/HCPCS code must describe the service performed.

If the provider of the service is other than the ordering/referring physician/nonphysician practitioner, that provider must maintain a copy of test results and interpretation, along with copies of the ordering/referring physician/nonphysician practitioner’s order for the studies. The clinical indication/medical necessity for the study must be indicated in the order for the test.

Utilization Guidelines

In accordance with CMS Ruling 95-1 (V), utilization of these services should be consistent with locally acceptable standards of practice.

Compliance with the provisions in LCD L36356 Bone Mineral Density Studies may be monitored and addressed through post payment data analysis and subsequent medical review audits.

Coding Information

CPT/HCPCS Codes

Group 1

(3 Codes)
Group 1 Paragraph

* Per CMS IOM Publication 100-04, Chapter 13, Section 140.1, CPT code 77080 or CPT code 77085 is covered when used to monitor FDA-approved osteoporosis drug therapy subject to the 2-year frequency standards described by CMS IOM Publication 100-02, Chapter 15, Section 80.5.5.

Group 1 Codes
CodeDescription
77080 DUAL-ENERGY X-RAY ABSORPTIOMETRY (DXA), BONE DENSITY STUDY, 1 OR MORE SITES; AXIAL SKELETON (EG, HIPS, PELVIS, SPINE)
77085 DUAL-ENERGY X-RAY ABSORPTIOMETRY (DXA), BONE DENSITY STUDY, 1 OR MORE SITES; AXIAL SKELETON (EG, HIPS, PELVIS, SPINE), INCLUDING VERTEBRAL FRACTURE ASSESSMENT
0508T PULSE-ECHO ULTRASOUND BONE DENSITY MEASUREMENT RESULTING IN INDICATOR OF AXIAL BONE MINERAL DENSITY, TIBIA

Group 2

(9 Codes)
Group 2 Paragraph

N/A

Group 2 Codes
CodeDescription
76977 ULTRASOUND BONE DENSITY MEASUREMENT AND INTERPRETATION, PERIPHERAL SITE(S), ANY METHOD
77078 COMPUTED TOMOGRAPHY, BONE MINERAL DENSITY STUDY, 1 OR MORE SITES, AXIAL SKELETON (EG, HIPS, PELVIS, SPINE)
77081 DUAL-ENERGY X-RAY ABSORPTIOMETRY (DXA), BONE DENSITY STUDY, 1 OR MORE SITES; APPENDICULAR SKELETON (PERIPHERAL) (EG, RADIUS, WRIST, HEEL)
G0130 SINGLE ENERGY X-RAY ABSORPTIOMETRY (SEXA) BONE DENSITY STUDY, ONE OR MORE SITES; APPENDICULAR SKELETON (PERIPHERAL) (E.G., RADIUS, WRIST, HEEL)
0554T BONE STRENGTH AND FRACTURE RISK USING FINITE ELEMENT ANALYSIS OF FUNCTIONAL DATA AND BONE-MINERAL DENSITY UTILIZING DATA FROM A COMPUTED TOMOGRAPHY SCAN; RETRIEVAL AND TRANSMISSION OF THE SCAN DATA, ASSESSMENT OF BONE STRENGTH AND FRACTURE RISK AND BONE-MINERAL DENSITY, INTERPRETATION AND REPORT
0555T BONE STRENGTH AND FRACTURE RISK USING FINITE ELEMENT ANALYSIS OF FUNCTIONAL DATA AND BONE-MINERAL DENSITY UTILIZING DATA FROM A COMPUTED TOMOGRAPHY SCAN; RETRIEVAL AND TRANSMISSION OF THE SCAN DATA
0556T BONE STRENGTH AND FRACTURE RISK USING FINITE ELEMENT ANALYSIS OF FUNCTIONAL DATA AND BONE-MINERAL DENSITY UTILIZING DATA FROM A COMPUTED TOMOGRAPHY SCAN; ASSESSMENT OF BONE STRENGTH AND FRACTURE RISK AND BONE-MINERAL DENSITY
0557T BONE STRENGTH AND FRACTURE RISK USING FINITE ELEMENT ANALYSIS OF FUNCTIONAL DATA AND BONE-MINERAL DENSITY UTILIZING DATA FROM A COMPUTED TOMOGRAPHY SCAN; INTERPRETATION AND REPORT
0558T COMPUTED TOMOGRAPHY SCAN TAKEN FOR THE PURPOSE OF BIOMECHANICAL COMPUTED TOMOGRAPHY ANALYSIS

CPT/HCPCS Modifiers

N/A

ICD-10-CM Codes that Support Medical Necessity

Group 1

(485 Codes)
Group 1 Paragraph

The following ICD-10-CM codes support medical necessity and provide limited coverage for CPT codes 77080, 77085, 0508T:

It is the provider’s responsibility to select codes carried out to the highest level of specificity and selected from the ICD-10-CM code book appropriate to the year in which the service is rendered for the claim(s) submitted.

Group 1 Codes
CodeDescription
E21.0 Primary hyperparathyroidism
E21.1 Secondary hyperparathyroidism, not elsewhere classified
E21.2 Other hyperparathyroidism
E21.3 Hyperparathyroidism, unspecified
E23.0 Hypopituitarism
E24.0 Pituitary-dependent Cushing's disease
E24.2 Drug-induced Cushing's syndrome
E24.3 Ectopic ACTH syndrome
E24.4 Alcohol-induced pseudo-Cushing's syndrome
E24.8 Other Cushing's syndrome
E24.9 Cushing's syndrome, unspecified
E28.310 Symptomatic premature menopause
E28.319 Asymptomatic premature menopause
E28.39 Other primary ovarian failure
E34.2 Ectopic hormone secretion, not elsewhere classified
E89.40 Asymptomatic postprocedural ovarian failure
E89.41 Symptomatic postprocedural ovarian failure
M48.40XA Fatigue fracture of vertebra, site unspecified, initial encounter for fracture
M48.41XA Fatigue fracture of vertebra, occipito-atlanto-axial region, initial encounter for fracture
M48.42XA Fatigue fracture of vertebra, cervical region, initial encounter for fracture
M48.43XA Fatigue fracture of vertebra, cervicothoracic region, initial encounter for fracture
M48.44XA Fatigue fracture of vertebra, thoracic region, initial encounter for fracture
M48.45XA Fatigue fracture of vertebra, thoracolumbar region, initial encounter for fracture
M48.46XA Fatigue fracture of vertebra, lumbar region, initial encounter for fracture
M48.47XA Fatigue fracture of vertebra, lumbosacral region, initial encounter for fracture
M48.48XA Fatigue fracture of vertebra, sacral and sacrococcygeal region, initial encounter for fracture
M48.50XA Collapsed vertebra, not elsewhere classified, site unspecified, initial encounter for fracture
M48.51XA Collapsed vertebra, not elsewhere classified, occipito-atlanto-axial region, initial encounter for fracture
M48.52XA Collapsed vertebra, not elsewhere classified, cervical region, initial encounter for fracture
M48.53XA Collapsed vertebra, not elsewhere classified, cervicothoracic region, initial encounter for fracture
M48.54XA Collapsed vertebra, not elsewhere classified, thoracic region, initial encounter for fracture
M48.55XA Collapsed vertebra, not elsewhere classified, thoracolumbar region, initial encounter for fracture
M48.56XA Collapsed vertebra, not elsewhere classified, lumbar region, initial encounter for fracture
M48.57XA Collapsed vertebra, not elsewhere classified, lumbosacral region, initial encounter for fracture
M48.58XA Collapsed vertebra, not elsewhere classified, sacral and sacrococcygeal region, initial encounter for fracture
M80.08XA Age-related osteoporosis with current pathological fracture, vertebra(e), initial encounter for fracture
M80.88XA Other osteoporosis with current pathological fracture, vertebra(e), initial encounter for fracture
M81.0 Age-related osteoporosis without current pathological fracture
M81.6 Localized osteoporosis [Lequesne]
M81.8 Other osteoporosis without current pathological fracture
M84.58XA Pathological fracture in neoplastic disease, other specified site, initial encounter for fracture
M84.68XA Pathological fracture in other disease, other site, initial encounter for fracture
M84.751A Incomplete atypical femoral fracture, right leg, initial encounter for fracture
M84.752A Incomplete atypical femoral fracture, left leg, initial encounter for fracture
M84.754A Complete transverse atypical femoral fracture, right leg, initial encounter for fracture
M84.755A Complete transverse atypical femoral fracture, left leg, initial encounter for fracture
M84.757A Complete oblique atypical femoral fracture, right leg, initial encounter for fracture
M84.758A Complete oblique atypical femoral fracture, left leg, initial encounter for fracture
M85.811 Other specified disorders of bone density and structure, right shoulder
M85.812 Other specified disorders of bone density and structure, left shoulder
M85.821 Other specified disorders of bone density and structure, right upper arm
M85.822 Other specified disorders of bone density and structure, left upper arm
M85.831 Other specified disorders of bone density and structure, right forearm
M85.832 Other specified disorders of bone density and structure, left forearm
M85.841 Other specified disorders of bone density and structure, right hand
M85.842 Other specified disorders of bone density and structure, left hand
M85.851 Other specified disorders of bone density and structure, right thigh
M85.852 Other specified disorders of bone density and structure, left thigh
M85.861 Other specified disorders of bone density and structure, right lower leg
M85.862 Other specified disorders of bone density and structure, left lower leg
M85.871 Other specified disorders of bone density and structure, right ankle and foot
M85.872 Other specified disorders of bone density and structure, left ankle and foot
M85.88 Other specified disorders of bone density and structure, other site
M85.89 Other specified disorders of bone density and structure, multiple sites
N95.1 Menopausal and female climacteric states
N95.8 Other specified menopausal and perimenopausal disorders
N95.9 Unspecified menopausal and perimenopausal disorder
Q78.0 Osteogenesis imperfecta
Q96.0 Karyotype 45, X
Q96.1 Karyotype 46, X iso (Xq)
Q96.2 Karyotype 46, X with abnormal sex chromosome, except iso (Xq)
Q96.3 Mosaicism, 45, X/46, XX or XY
Q96.4 Mosaicism, 45, X/other cell line(s) with abnormal sex chromosome
Q96.8 Other variants of Turner's syndrome
Q96.9 Turner's syndrome, unspecified
S12.000A Unspecified displaced fracture of first cervical vertebra, initial encounter for closed fracture
S12.000B Unspecified displaced fracture of first cervical vertebra, initial encounter for open fracture
S12.001A Unspecified nondisplaced fracture of first cervical vertebra, initial encounter for closed fracture
S12.001B Unspecified nondisplaced fracture of first cervical vertebra, initial encounter for open fracture
S12.01XA Stable burst fracture of first cervical vertebra, initial encounter for closed fracture
S12.01XB Stable burst fracture of first cervical vertebra, initial encounter for open fracture
S12.02XA Unstable burst fracture of first cervical vertebra, initial encounter for closed fracture
S12.02XB Unstable burst fracture of first cervical vertebra, initial encounter for open fracture
S12.030A Displaced posterior arch fracture of first cervical vertebra, initial encounter for closed fracture
S12.030B Displaced posterior arch fracture of first cervical vertebra, initial encounter for open fracture
S12.031A Nondisplaced posterior arch fracture of first cervical vertebra, initial encounter for closed fracture
S12.031B Nondisplaced posterior arch fracture of first cervical vertebra, initial encounter for open fracture
S12.040A Displaced lateral mass fracture of first cervical vertebra, initial encounter for closed fracture
S12.040B Displaced lateral mass fracture of first cervical vertebra, initial encounter for open fracture
S12.041A Nondisplaced lateral mass fracture of first cervical vertebra, initial encounter for closed fracture
S12.041B Nondisplaced lateral mass fracture of first cervical vertebra, initial encounter for open fracture
S12.090A Other displaced fracture of first cervical vertebra, initial encounter for closed fracture
S12.090B Other displaced fracture of first cervical vertebra, initial encounter for open fracture
S12.091A Other nondisplaced fracture of first cervical vertebra, initial encounter for closed fracture
S12.091B Other nondisplaced fracture of first cervical vertebra, initial encounter for open fracture
S12.100A Unspecified displaced fracture of second cervical vertebra, initial encounter for closed fracture
S12.100B Unspecified displaced fracture of second cervical vertebra, initial encounter for open fracture
S12.101A Unspecified nondisplaced fracture of second cervical vertebra, initial encounter for closed fracture
S12.101B Unspecified nondisplaced fracture of second cervical vertebra, initial encounter for open fracture
S12.110A Anterior displaced Type II dens fracture, initial encounter for closed fracture
S12.110B Anterior displaced Type II dens fracture, initial encounter for open fracture
S12.111A Posterior displaced Type II dens fracture, initial encounter for closed fracture
S12.111B Posterior displaced Type II dens fracture, initial encounter for open fracture
S12.112A Nondisplaced Type II dens fracture, initial encounter for closed fracture
S12.112B Nondisplaced Type II dens fracture, initial encounter for open fracture
S12.120A Other displaced dens fracture, initial encounter for closed fracture
S12.120B Other displaced dens fracture, initial encounter for open fracture
S12.121A Other nondisplaced dens fracture, initial encounter for closed fracture
S12.121B Other nondisplaced dens fracture, initial encounter for open fracture
S12.130A Unspecified traumatic displaced spondylolisthesis of second cervical vertebra, initial encounter for closed fracture
S12.130B Unspecified traumatic displaced spondylolisthesis of second cervical vertebra, initial encounter for open fracture
S12.131A Unspecified traumatic nondisplaced spondylolisthesis of second cervical vertebra, initial encounter for closed fracture
S12.131B Unspecified traumatic nondisplaced spondylolisthesis of second cervical vertebra, initial encounter for open fracture
S12.14XA Type III traumatic spondylolisthesis of second cervical vertebra, initial encounter for closed fracture
S12.14XB Type III traumatic spondylolisthesis of second cervical vertebra, initial encounter for open fracture
S12.150A Other traumatic displaced spondylolisthesis of second cervical vertebra, initial encounter for closed fracture
S12.150B Other traumatic displaced spondylolisthesis of second cervical vertebra, initial encounter for open fracture
S12.151A Other traumatic nondisplaced spondylolisthesis of second cervical vertebra, initial encounter for closed fracture
S12.151B Other traumatic nondisplaced spondylolisthesis of second cervical vertebra, initial encounter for open fracture
S12.190A Other displaced fracture of second cervical vertebra, initial encounter for closed fracture
S12.190B Other displaced fracture of second cervical vertebra, initial encounter for open fracture
S12.191A Other nondisplaced fracture of second cervical vertebra, initial encounter for closed fracture
S12.191B Other nondisplaced fracture of second cervical vertebra, initial encounter for open fracture
S12.200A Unspecified displaced fracture of third cervical vertebra, initial encounter for closed fracture
S12.200B Unspecified displaced fracture of third cervical vertebra, initial encounter for open fracture
S12.201A Unspecified nondisplaced fracture of third cervical vertebra, initial encounter for closed fracture
S12.201B Unspecified nondisplaced fracture of third cervical vertebra, initial encounter for open fracture
S12.230A Unspecified traumatic displaced spondylolisthesis of third cervical vertebra, initial encounter for closed fracture
S12.230B Unspecified traumatic displaced spondylolisthesis of third cervical vertebra, initial encounter for open fracture
S12.231A Unspecified traumatic nondisplaced spondylolisthesis of third cervical vertebra, initial encounter for closed fracture
S12.231B Unspecified traumatic nondisplaced spondylolisthesis of third cervical vertebra, initial encounter for open fracture
S12.24XA Type III traumatic spondylolisthesis of third cervical vertebra, initial encounter for closed fracture
S12.24XB Type III traumatic spondylolisthesis of third cervical vertebra, initial encounter for open fracture
S12.250A Other traumatic displaced spondylolisthesis of third cervical vertebra, initial encounter for closed fracture
S12.250B Other traumatic displaced spondylolisthesis of third cervical vertebra, initial encounter for open fracture
S12.251A Other traumatic nondisplaced spondylolisthesis of third cervical vertebra, initial encounter for closed fracture
S12.251B Other traumatic nondisplaced spondylolisthesis of third cervical vertebra, initial encounter for open fracture
S12.290A Other displaced fracture of third cervical vertebra, initial encounter for closed fracture
S12.290B Other displaced fracture of third cervical vertebra, initial encounter for open fracture
S12.291A Other nondisplaced fracture of third cervical vertebra, initial encounter for closed fracture
S12.291B Other nondisplaced fracture of third cervical vertebra, initial encounter for open fracture
S12.300A Unspecified displaced fracture of fourth cervical vertebra, initial encounter for closed fracture
S12.300B Unspecified displaced fracture of fourth cervical vertebra, initial encounter for open fracture
S12.301A Unspecified nondisplaced fracture of fourth cervical vertebra, initial encounter for closed fracture
S12.301B Unspecified nondisplaced fracture of fourth cervical vertebra, initial encounter for open fracture
S12.330A Unspecified traumatic displaced spondylolisthesis of fourth cervical vertebra, initial encounter for closed fracture
S12.330B Unspecified traumatic displaced spondylolisthesis of fourth cervical vertebra, initial encounter for open fracture
S12.331A Unspecified traumatic nondisplaced spondylolisthesis of fourth cervical vertebra, initial encounter for closed fracture
S12.331B Unspecified traumatic nondisplaced spondylolisthesis of fourth cervical vertebra, initial encounter for open fracture
S12.34XA Type III traumatic spondylolisthesis of fourth cervical vertebra, initial encounter for closed fracture
S12.34XB Type III traumatic spondylolisthesis of fourth cervical vertebra, initial encounter for open fracture
S12.350A Other traumatic displaced spondylolisthesis of fourth cervical vertebra, initial encounter for closed fracture
S12.350B Other traumatic displaced spondylolisthesis of fourth cervical vertebra, initial encounter for open fracture
S12.351A Other traumatic nondisplaced spondylolisthesis of fourth cervical vertebra, initial encounter for closed fracture
S12.351B Other traumatic nondisplaced spondylolisthesis of fourth cervical vertebra, initial encounter for open fracture
S12.390A Other displaced fracture of fourth cervical vertebra, initial encounter for closed fracture
S12.390B Other displaced fracture of fourth cervical vertebra, initial encounter for open fracture
S12.391A Other nondisplaced fracture of fourth cervical vertebra, initial encounter for closed fracture
S12.391B Other nondisplaced fracture of fourth cervical vertebra, initial encounter for open fracture
S12.400A Unspecified displaced fracture of fifth cervical vertebra, initial encounter for closed fracture
S12.400B Unspecified displaced fracture of fifth cervical vertebra, initial encounter for open fracture
S12.401A Unspecified nondisplaced fracture of fifth cervical vertebra, initial encounter for closed fracture
S12.401B Unspecified nondisplaced fracture of fifth cervical vertebra, initial encounter for open fracture
S12.430A Unspecified traumatic displaced spondylolisthesis of fifth cervical vertebra, initial encounter for closed fracture
S12.430B Unspecified traumatic displaced spondylolisthesis of fifth cervical vertebra, initial encounter for open fracture
S12.431A Unspecified traumatic nondisplaced spondylolisthesis of fifth cervical vertebra, initial encounter for closed fracture
S12.431B Unspecified traumatic nondisplaced spondylolisthesis of fifth cervical vertebra, initial encounter for open fracture
S12.44XA Type III traumatic spondylolisthesis of fifth cervical vertebra, initial encounter for closed fracture
S12.44XB Type III traumatic spondylolisthesis of fifth cervical vertebra, initial encounter for open fracture
S12.450A Other traumatic displaced spondylolisthesis of fifth cervical vertebra, initial encounter for closed fracture
S12.450B Other traumatic displaced spondylolisthesis of fifth cervical vertebra, initial encounter for open fracture
S12.451A Other traumatic nondisplaced spondylolisthesis of fifth cervical vertebra, initial encounter for closed fracture
S12.451B Other traumatic nondisplaced spondylolisthesis of fifth cervical vertebra, initial encounter for open fracture
S12.490A Other displaced fracture of fifth cervical vertebra, initial encounter for closed fracture
S12.490B Other displaced fracture of fifth cervical vertebra, initial encounter for open fracture
S12.491A Other nondisplaced fracture of fifth cervical vertebra, initial encounter for closed fracture
S12.491B Other nondisplaced fracture of fifth cervical vertebra, initial encounter for open fracture
S12.500A Unspecified displaced fracture of sixth cervical vertebra, initial encounter for closed fracture
S12.500B Unspecified displaced fracture of sixth cervical vertebra, initial encounter for open fracture
S12.501A Unspecified nondisplaced fracture of sixth cervical vertebra, initial encounter for closed fracture
S12.501B Unspecified nondisplaced fracture of sixth cervical vertebra, initial encounter for open fracture
S12.530A Unspecified traumatic displaced spondylolisthesis of sixth cervical vertebra, initial encounter for closed fracture
S12.530B Unspecified traumatic displaced spondylolisthesis of sixth cervical vertebra, initial encounter for open fracture
S12.531A Unspecified traumatic nondisplaced spondylolisthesis of sixth cervical vertebra, initial encounter for closed fracture
S12.531B Unspecified traumatic nondisplaced spondylolisthesis of sixth cervical vertebra, initial encounter for open fracture
S12.54XA Type III traumatic spondylolisthesis of sixth cervical vertebra, initial encounter for closed fracture
S12.54XB Type III traumatic spondylolisthesis of sixth cervical vertebra, initial encounter for open fracture
S12.550A Other traumatic displaced spondylolisthesis of sixth cervical vertebra, initial encounter for closed fracture
S12.550B Other traumatic displaced spondylolisthesis of sixth cervical vertebra, initial encounter for open fracture
S12.551A Other traumatic nondisplaced spondylolisthesis of sixth cervical vertebra, initial encounter for closed fracture
S12.551B Other traumatic nondisplaced spondylolisthesis of sixth cervical vertebra, initial encounter for open fracture
S12.590A Other displaced fracture of sixth cervical vertebra, initial encounter for closed fracture
S12.590B Other displaced fracture of sixth cervical vertebra, initial encounter for open fracture
S12.591A Other nondisplaced fracture of sixth cervical vertebra, initial encounter for closed fracture
S12.591B Other nondisplaced fracture of sixth cervical vertebra, initial encounter for open fracture
S12.600A Unspecified displaced fracture of seventh cervical vertebra, initial encounter for closed fracture
S12.600B Unspecified displaced fracture of seventh cervical vertebra, initial encounter for open fracture
S12.601A Unspecified nondisplaced fracture of seventh cervical vertebra, initial encounter for closed fracture
S12.601B Unspecified nondisplaced fracture of seventh cervical vertebra, initial encounter for open fracture
S12.630A Unspecified traumatic displaced spondylolisthesis of seventh cervical vertebra, initial encounter for closed fracture
S12.630B Unspecified traumatic displaced spondylolisthesis of seventh cervical vertebra, initial encounter for open fracture
S12.631A Unspecified traumatic nondisplaced spondylolisthesis of seventh cervical vertebra, initial encounter for closed fracture
S12.631B Unspecified traumatic nondisplaced spondylolisthesis of seventh cervical vertebra, initial encounter for open fracture
S12.64XA Type III traumatic spondylolisthesis of seventh cervical vertebra, initial encounter for closed fracture
S12.64XB Type III traumatic spondylolisthesis of seventh cervical vertebra, initial encounter for open fracture
S12.650A Other traumatic displaced spondylolisthesis of seventh cervical vertebra, initial encounter for closed fracture
S12.650B Other traumatic displaced spondylolisthesis of seventh cervical vertebra, initial encounter for open fracture
S12.651A Other traumatic nondisplaced spondylolisthesis of seventh cervical vertebra, initial encounter for closed fracture
S12.651B Other traumatic nondisplaced spondylolisthesis of seventh cervical vertebra, initial encounter for open fracture
S12.690A Other displaced fracture of seventh cervical vertebra, initial encounter for closed fracture
S12.690B Other displaced fracture of seventh cervical vertebra, initial encounter for open fracture
S12.691A Other nondisplaced fracture of seventh cervical vertebra, initial encounter for closed fracture
S12.691B Other nondisplaced fracture of seventh cervical vertebra, initial encounter for open fracture
S12.9XXA Fracture of neck, unspecified, initial encounter
S14.101A Unspecified injury at C1 level of cervical spinal cord, initial encounter
S14.102A Unspecified injury at C2 level of cervical spinal cord, initial encounter
S14.103A Unspecified injury at C3 level of cervical spinal cord, initial encounter
S14.104A Unspecified injury at C4 level of cervical spinal cord, initial encounter
S14.105A Unspecified injury at C5 level of cervical spinal cord, initial encounter
S14.106A Unspecified injury at C6 level of cervical spinal cord, initial encounter
S14.107A Unspecified injury at C7 level of cervical spinal cord, initial encounter
S14.109A Unspecified injury at unspecified level of cervical spinal cord, initial encounter
S14.111A Complete lesion at C1 level of cervical spinal cord, initial encounter
S14.112A Complete lesion at C2 level of cervical spinal cord, initial encounter
S14.113A Complete lesion at C3 level of cervical spinal cord, initial encounter
S14.114A Complete lesion at C4 level of cervical spinal cord, initial encounter
S14.115A Complete lesion at C5 level of cervical spinal cord, initial encounter
S14.116A Complete lesion at C6 level of cervical spinal cord, initial encounter
S14.117A Complete lesion at C7 level of cervical spinal cord, initial encounter
S14.121A Central cord syndrome at C1 level of cervical spinal cord, initial encounter
S14.122A Central cord syndrome at C2 level of cervical spinal cord, initial encounter
S14.123A Central cord syndrome at C3 level of cervical spinal cord, initial encounter
S14.124A Central cord syndrome at C4 level of cervical spinal cord, initial encounter
S14.125A Central cord syndrome at C5 level of cervical spinal cord, initial encounter
S14.126A Central cord syndrome at C6 level of cervical spinal cord, initial encounter
S14.127A Central cord syndrome at C7 level of cervical spinal cord, initial encounter
S14.131A Anterior cord syndrome at C1 level of cervical spinal cord, initial encounter
S14.132A Anterior cord syndrome at C2 level of cervical spinal cord, initial encounter
S14.133A Anterior cord syndrome at C3 level of cervical spinal cord, initial encounter
S14.134A Anterior cord syndrome at C4 level of cervical spinal cord, initial encounter
S14.135A Anterior cord syndrome at C5 level of cervical spinal cord, initial encounter
S14.136A Anterior cord syndrome at C6 level of cervical spinal cord, initial encounter
S14.137A Anterior cord syndrome at C7 level of cervical spinal cord, initial encounter
S14.151A Other incomplete lesion at C1 level of cervical spinal cord, initial encounter
S14.152A Other incomplete lesion at C2 level of cervical spinal cord, initial encounter
S14.153A Other incomplete lesion at C3 level of cervical spinal cord, initial encounter
S14.154A Other incomplete lesion at C4 level of cervical spinal cord, initial encounter
S14.155A Other incomplete lesion at C5 level of cervical spinal cord, initial encounter
S14.156A Other incomplete lesion at C6 level of cervical spinal cord, initial encounter
S14.157A Other incomplete lesion at C7 level of cervical spinal cord, initial encounter
S22.000A Wedge compression fracture of unspecified thoracic vertebra, initial encounter for closed fracture
S22.000B Wedge compression fracture of unspecified thoracic vertebra, initial encounter for open fracture
S22.001A Stable burst fracture of unspecified thoracic vertebra, initial encounter for closed fracture
S22.001B Stable burst fracture of unspecified thoracic vertebra, initial encounter for open fracture
S22.002A Unstable burst fracture of unspecified thoracic vertebra, initial encounter for closed fracture
S22.002B Unstable burst fracture of unspecified thoracic vertebra, initial encounter for open fracture
S22.008A Other fracture of unspecified thoracic vertebra, initial encounter for closed fracture
S22.008B Other fracture of unspecified thoracic vertebra, initial encounter for open fracture
S22.009A Unspecified fracture of unspecified thoracic vertebra, initial encounter for closed fracture
S22.009B Unspecified fracture of unspecified thoracic vertebra, initial encounter for open fracture
S22.010A Wedge compression fracture of first thoracic vertebra, initial encounter for closed fracture
S22.010B Wedge compression fracture of first thoracic vertebra, initial encounter for open fracture
S22.011A Stable burst fracture of first thoracic vertebra, initial encounter for closed fracture
S22.011B Stable burst fracture of first thoracic vertebra, initial encounter for open fracture
S22.012A Unstable burst fracture of first thoracic vertebra, initial encounter for closed fracture
S22.012B Unstable burst fracture of first thoracic vertebra, initial encounter for open fracture
S22.018A Other fracture of first thoracic vertebra, initial encounter for closed fracture
S22.018B Other fracture of first thoracic vertebra, initial encounter for open fracture
S22.019A Unspecified fracture of first thoracic vertebra, initial encounter for closed fracture
S22.019B Unspecified fracture of first thoracic vertebra, initial encounter for open fracture
S22.020A Wedge compression fracture of second thoracic vertebra, initial encounter for closed fracture
S22.020B Wedge compression fracture of second thoracic vertebra, initial encounter for open fracture
S22.021A Stable burst fracture of second thoracic vertebra, initial encounter for closed fracture
S22.021B Stable burst fracture of second thoracic vertebra, initial encounter for open fracture
S22.022A Unstable burst fracture of second thoracic vertebra, initial encounter for closed fracture
S22.022B Unstable burst fracture of second thoracic vertebra, initial encounter for open fracture
S22.028A Other fracture of second thoracic vertebra, initial encounter for closed fracture
S22.028B Other fracture of second thoracic vertebra, initial encounter for open fracture
S22.029A Unspecified fracture of second thoracic vertebra, initial encounter for closed fracture
S22.029B Unspecified fracture of second thoracic vertebra, initial encounter for open fracture
S22.030A Wedge compression fracture of third thoracic vertebra, initial encounter for closed fracture
S22.030B Wedge compression fracture of third thoracic vertebra, initial encounter for open fracture
S22.031A Stable burst fracture of third thoracic vertebra, initial encounter for closed fracture
S22.031B Stable burst fracture of third thoracic vertebra, initial encounter for open fracture
S22.032A Unstable burst fracture of third thoracic vertebra, initial encounter for closed fracture
S22.032B Unstable burst fracture of third thoracic vertebra, initial encounter for open fracture
S22.038A Other fracture of third thoracic vertebra, initial encounter for closed fracture
S22.038B Other fracture of third thoracic vertebra, initial encounter for open fracture
S22.039A Unspecified fracture of third thoracic vertebra, initial encounter for closed fracture
S22.039B Unspecified fracture of third thoracic vertebra, initial encounter for open fracture
S22.040A Wedge compression fracture of fourth thoracic vertebra, initial encounter for closed fracture
S22.040B Wedge compression fracture of fourth thoracic vertebra, initial encounter for open fracture
S22.041A Stable burst fracture of fourth thoracic vertebra, initial encounter for closed fracture
S22.041B Stable burst fracture of fourth thoracic vertebra, initial encounter for open fracture
S22.042A Unstable burst fracture of fourth thoracic vertebra, initial encounter for closed fracture
S22.042B Unstable burst fracture of fourth thoracic vertebra, initial encounter for open fracture
S22.048A Other fracture of fourth thoracic vertebra, initial encounter for closed fracture
S22.048B Other fracture of fourth thoracic vertebra, initial encounter for open fracture
S22.049A Unspecified fracture of fourth thoracic vertebra, initial encounter for closed fracture
S22.049B Unspecified fracture of fourth thoracic vertebra, initial encounter for open fracture
S22.050A Wedge compression fracture of T5-T6 vertebra, initial encounter for closed fracture
S22.050B Wedge compression fracture of T5-T6 vertebra, initial encounter for open fracture
S22.051A Stable burst fracture of T5-T6 vertebra, initial encounter for closed fracture
S22.051B Stable burst fracture of T5-T6 vertebra, initial encounter for open fracture
S22.052A Unstable burst fracture of T5-T6 vertebra, initial encounter for closed fracture
S22.052B Unstable burst fracture of T5-T6 vertebra, initial encounter for open fracture
S22.058A Other fracture of T5-T6 vertebra, initial encounter for closed fracture
S22.058B Other fracture of T5-T6 vertebra, initial encounter for open fracture
S22.059A Unspecified fracture of T5-T6 vertebra, initial encounter for closed fracture
S22.059B Unspecified fracture of T5-T6 vertebra, initial encounter for open fracture
S22.060A Wedge compression fracture of T7-T8 vertebra, initial encounter for closed fracture
S22.060B Wedge compression fracture of T7-T8 vertebra, initial encounter for open fracture
S22.061A Stable burst fracture of T7-T8 vertebra, initial encounter for closed fracture
S22.061B Stable burst fracture of T7-T8 vertebra, initial encounter for open fracture
S22.062A Unstable burst fracture of T7-T8 vertebra, initial encounter for closed fracture
S22.062B Unstable burst fracture of T7-T8 vertebra, initial encounter for open fracture
S22.068A Other fracture of T7-T8 thoracic vertebra, initial encounter for closed fracture
S22.068B Other fracture of T7-T8 thoracic vertebra, initial encounter for open fracture
S22.069A Unspecified fracture of T7-T8 vertebra, initial encounter for closed fracture
S22.069B Unspecified fracture of T7-T8 vertebra, initial encounter for open fracture
S22.070A Wedge compression fracture of T9-T10 vertebra, initial encounter for closed fracture
S22.070B Wedge compression fracture of T9-T10 vertebra, initial encounter for open fracture
S22.071A Stable burst fracture of T9-T10 vertebra, initial encounter for closed fracture
S22.071B Stable burst fracture of T9-T10 vertebra, initial encounter for open fracture
S22.072A Unstable burst fracture of T9-T10 vertebra, initial encounter for closed fracture
S22.072B Unstable burst fracture of T9-T10 vertebra, initial encounter for open fracture
S22.078A Other fracture of T9-T10 vertebra, initial encounter for closed fracture
S22.078B Other fracture of T9-T10 vertebra, initial encounter for open fracture
S22.079A Unspecified fracture of T9-T10 vertebra, initial encounter for closed fracture
S22.079B Unspecified fracture of T9-T10 vertebra, initial encounter for open fracture
S22.080A Wedge compression fracture of T11-T12 vertebra, initial encounter for closed fracture
S22.080B Wedge compression fracture of T11-T12 vertebra, initial encounter for open fracture
S22.081A Stable burst fracture of T11-T12 vertebra, initial encounter for closed fracture
S22.081B Stable burst fracture of T11-T12 vertebra, initial encounter for open fracture
S22.082A Unstable burst fracture of T11-T12 vertebra, initial encounter for closed fracture
S22.082B Unstable burst fracture of T11-T12 vertebra, initial encounter for open fracture
S22.088A Other fracture of T11-T12 vertebra, initial encounter for closed fracture
S22.088B Other fracture of T11-T12 vertebra, initial encounter for open fracture
S22.089A Unspecified fracture of T11-T12 vertebra, initial encounter for closed fracture
S22.089B Unspecified fracture of T11-T12 vertebra, initial encounter for open fracture
S24.101A Unspecified injury at T1 level of thoracic spinal cord, initial encounter
S24.102A Unspecified injury at T2-T6 level of thoracic spinal cord, initial encounter
S24.103A Unspecified injury at T7-T10 level of thoracic spinal cord, initial encounter
S24.104A Unspecified injury at T11-T12 level of thoracic spinal cord, initial encounter
S24.109A Unspecified injury at unspecified level of thoracic spinal cord, initial encounter
S24.111A Complete lesion at T1 level of thoracic spinal cord, initial encounter
S24.112A Complete lesion at T2-T6 level of thoracic spinal cord, initial encounter
S24.113A Complete lesion at T7-T10 level of thoracic spinal cord, initial encounter
S24.114A Complete lesion at T11-T12 level of thoracic spinal cord, initial encounter
S24.131A Anterior cord syndrome at T1 level of thoracic spinal cord, initial encounter
S24.132A Anterior cord syndrome at T2-T6 level of thoracic spinal cord, initial encounter
S24.133A Anterior cord syndrome at T7-T10 level of thoracic spinal cord, initial encounter
S24.134A Anterior cord syndrome at T11-T12 level of thoracic spinal cord, initial encounter
S24.151A Other incomplete lesion at T1 level of thoracic spinal cord, initial encounter
S24.152A Other incomplete lesion at T2-T6 level of thoracic spinal cord, initial encounter
S24.153A Other incomplete lesion at T7-T10 level of thoracic spinal cord, initial encounter
S24.154A Other incomplete lesion at T11-T12 level of thoracic spinal cord, initial encounter
S32.000A Wedge compression fracture of unspecified lumbar vertebra, initial encounter for closed fracture
S32.000B Wedge compression fracture of unspecified lumbar vertebra, initial encounter for open fracture
S32.001A Stable burst fracture of unspecified lumbar vertebra, initial encounter for closed fracture
S32.001B Stable burst fracture of unspecified lumbar vertebra, initial encounter for open fracture
S32.002A Unstable burst fracture of unspecified lumbar vertebra, initial encounter for closed fracture
S32.002B Unstable burst fracture of unspecified lumbar vertebra, initial encounter for open fracture
S32.008A Other fracture of unspecified lumbar vertebra, initial encounter for closed fracture
S32.008B Other fracture of unspecified lumbar vertebra, initial encounter for open fracture
S32.009A Unspecified fracture of unspecified lumbar vertebra, initial encounter for closed fracture
S32.009B Unspecified fracture of unspecified lumbar vertebra, initial encounter for open fracture
S32.010A Wedge compression fracture of first lumbar vertebra, initial encounter for closed fracture
S32.010B Wedge compression fracture of first lumbar vertebra, initial encounter for open fracture
S32.011A Stable burst fracture of first lumbar vertebra, initial encounter for closed fracture
S32.011B Stable burst fracture of first lumbar vertebra, initial encounter for open fracture
S32.012A Unstable burst fracture of first lumbar vertebra, initial encounter for closed fracture
S32.012B Unstable burst fracture of first lumbar vertebra, initial encounter for open fracture
S32.018A Other fracture of first lumbar vertebra, initial encounter for closed fracture
S32.018B Other fracture of first lumbar vertebra, initial encounter for open fracture
S32.019A Unspecified fracture of first lumbar vertebra, initial encounter for closed fracture
S32.019B Unspecified fracture of first lumbar vertebra, initial encounter for open fracture
S32.020A Wedge compression fracture of second lumbar vertebra, initial encounter for closed fracture
S32.020B Wedge compression fracture of second lumbar vertebra, initial encounter for open fracture
S32.021A Stable burst fracture of second lumbar vertebra, initial encounter for closed fracture
S32.021B Stable burst fracture of second lumbar vertebra, initial encounter for open fracture
S32.022A Unstable burst fracture of second lumbar vertebra, initial encounter for closed fracture
S32.022B Unstable burst fracture of second lumbar vertebra, initial encounter for open fracture
S32.028A Other fracture of second lumbar vertebra, initial encounter for closed fracture
S32.028B Other fracture of second lumbar vertebra, initial encounter for open fracture
S32.029A Unspecified fracture of second lumbar vertebra, initial encounter for closed fracture
S32.029B Unspecified fracture of second lumbar vertebra, initial encounter for open fracture
S32.030A Wedge compression fracture of third lumbar vertebra, initial encounter for closed fracture
S32.030B Wedge compression fracture of third lumbar vertebra, initial encounter for open fracture
S32.031A Stable burst fracture of third lumbar vertebra, initial encounter for closed fracture
S32.031B Stable burst fracture of third lumbar vertebra, initial encounter for open fracture
S32.032A Unstable burst fracture of third lumbar vertebra, initial encounter for closed fracture
S32.032B Unstable burst fracture of third lumbar vertebra, initial encounter for open fracture
S32.038A Other fracture of third lumbar vertebra, initial encounter for closed fracture
S32.038B Other fracture of third lumbar vertebra, initial encounter for open fracture
S32.039A Unspecified fracture of third lumbar vertebra, initial encounter for closed fracture
S32.039B Unspecified fracture of third lumbar vertebra, initial encounter for open fracture
S32.040A Wedge compression fracture of fourth lumbar vertebra, initial encounter for closed fracture
S32.040B Wedge compression fracture of fourth lumbar vertebra, initial encounter for open fracture
S32.041A Stable burst fracture of fourth lumbar vertebra, initial encounter for closed fracture
S32.041B Stable burst fracture of fourth lumbar vertebra, initial encounter for open fracture
S32.042A Unstable burst fracture of fourth lumbar vertebra, initial encounter for closed fracture
S32.042B Unstable burst fracture of fourth lumbar vertebra, initial encounter for open fracture
S32.048A Other fracture of fourth lumbar vertebra, initial encounter for closed fracture
S32.048B Other fracture of fourth lumbar vertebra, initial encounter for open fracture
S32.049A Unspecified fracture of fourth lumbar vertebra, initial encounter for closed fracture
S32.049B Unspecified fracture of fourth lumbar vertebra, initial encounter for open fracture
S32.050A Wedge compression fracture of fifth lumbar vertebra, initial encounter for closed fracture
S32.050B Wedge compression fracture of fifth lumbar vertebra, initial encounter for open fracture
S32.051A Stable burst fracture of fifth lumbar vertebra, initial encounter for closed fracture
S32.051B Stable burst fracture of fifth lumbar vertebra, initial encounter for open fracture
S32.052A Unstable burst fracture of fifth lumbar vertebra, initial encounter for closed fracture
S32.052B Unstable burst fracture of fifth lumbar vertebra, initial encounter for open fracture
S32.058A Other fracture of fifth lumbar vertebra, initial encounter for closed fracture
S32.058B Other fracture of fifth lumbar vertebra, initial encounter for open fracture
S32.059A Unspecified fracture of fifth lumbar vertebra, initial encounter for closed fracture
S32.059B Unspecified fracture of fifth lumbar vertebra, initial encounter for open fracture
S32.10XA Unspecified fracture of sacrum, initial encounter for closed fracture
S32.10XB Unspecified fracture of sacrum, initial encounter for open fracture
S32.110A Nondisplaced Zone I fracture of sacrum, initial encounter for closed fracture
S32.110B Nondisplaced Zone I fracture of sacrum, initial encounter for open fracture
S32.111A Minimally displaced Zone I fracture of sacrum, initial encounter for closed fracture
S32.111B Minimally displaced Zone I fracture of sacrum, initial encounter for open fracture
S32.112A Severely displaced Zone I fracture of sacrum, initial encounter for closed fracture
S32.112B Severely displaced Zone I fracture of sacrum, initial encounter for open fracture
S32.119A Unspecified Zone I fracture of sacrum, initial encounter for closed fracture
S32.119B Unspecified Zone I fracture of sacrum, initial encounter for open fracture
S32.120A Nondisplaced Zone II fracture of sacrum, initial encounter for closed fracture
S32.120B Nondisplaced Zone II fracture of sacrum, initial encounter for open fracture
S32.121A Minimally displaced Zone II fracture of sacrum, initial encounter for closed fracture
S32.121B Minimally displaced Zone II fracture of sacrum, initial encounter for open fracture
S32.122A Severely displaced Zone II fracture of sacrum, initial encounter for closed fracture
S32.122B Severely displaced Zone II fracture of sacrum, initial encounter for open fracture
S32.129A Unspecified Zone II fracture of sacrum, initial encounter for closed fracture
S32.129B Unspecified Zone II fracture of sacrum, initial encounter for open fracture
S32.130A Nondisplaced Zone III fracture of sacrum, initial encounter for closed fracture
S32.130B Nondisplaced Zone III fracture of sacrum, initial encounter for open fracture
S32.131A Minimally displaced Zone III fracture of sacrum, initial encounter for closed fracture
S32.131B Minimally displaced Zone III fracture of sacrum, initial encounter for open fracture
S32.132A Severely displaced Zone III fracture of sacrum, initial encounter for closed fracture
S32.132B Severely displaced Zone III fracture of sacrum, initial encounter for open fracture
S32.139A Unspecified Zone III fracture of sacrum, initial encounter for closed fracture
S32.139B Unspecified Zone III fracture of sacrum, initial encounter for open fracture
S32.14XA Type 1 fracture of sacrum, initial encounter for closed fracture
S32.14XB Type 1 fracture of sacrum, initial encounter for open fracture
S32.15XA Type 2 fracture of sacrum, initial encounter for closed fracture
S32.15XB Type 2 fracture of sacrum, initial encounter for open fracture
S32.16XA Type 3 fracture of sacrum, initial encounter for closed fracture
S32.16XB Type 3 fracture of sacrum, initial encounter for open fracture
S32.17XA Type 4 fracture of sacrum, initial encounter for closed fracture
S32.17XB Type 4 fracture of sacrum, initial encounter for open fracture
S32.19XA Other fracture of sacrum, initial encounter for closed fracture
S32.19XB Other fracture of sacrum, initial encounter for open fracture
S32.2XXA Fracture of coccyx, initial encounter for closed fracture
S32.2XXB Fracture of coccyx, initial encounter for open fracture
S34.101A Unspecified injury to L1 level of lumbar spinal cord, initial encounter
S34.102A Unspecified injury to L2 level of lumbar spinal cord, initial encounter
S34.103A Unspecified injury to L3 level of lumbar spinal cord, initial encounter
S34.104A Unspecified injury to L4 level of lumbar spinal cord, initial encounter
S34.105A Unspecified injury to L5 level of lumbar spinal cord, initial encounter
S34.109A Unspecified injury to unspecified level of lumbar spinal cord, initial encounter
S34.111A Complete lesion of L1 level of lumbar spinal cord, initial encounter
S34.112A Complete lesion of L2 level of lumbar spinal cord, initial encounter
S34.113A Complete lesion of L3 level of lumbar spinal cord, initial encounter
S34.114A Complete lesion of L4 level of lumbar spinal cord, initial encounter
S34.115A Complete lesion of L5 level of lumbar spinal cord, initial encounter
S34.119A Complete lesion of unspecified level of lumbar spinal cord, initial encounter
S34.121A Incomplete lesion of L1 level of lumbar spinal cord, initial encounter
S34.122A Incomplete lesion of L2 level of lumbar spinal cord, initial encounter
S34.123A Incomplete lesion of L3 level of lumbar spinal cord, initial encounter
S34.124A Incomplete lesion of L4 level of lumbar spinal cord, initial encounter
S34.125A Incomplete lesion of L5 level of lumbar spinal cord, initial encounter
S34.129A Incomplete lesion of unspecified level of lumbar spinal cord, initial encounter
S34.131A Complete lesion of sacral spinal cord, initial encounter
S34.132A Incomplete lesion of sacral spinal cord, initial encounter
S34.139A Unspecified injury to sacral spinal cord, initial encounter
S34.3XXA Injury of cauda equina, initial encounter
Z78.0 Asymptomatic menopausal state
Z79.3 Long term (current) use of hormonal contraceptives
Z79.51 Long term (current) use of inhaled steroids
Z79.52 Long term (current) use of systemic steroids
Z79.811 Long term (current) use of aromatase inhibitors
Z79.818 Long term (current) use of other agents affecting estrogen receptors and estrogen levels
Z79.83 Long term (current) use of bisphosphonates
Z87.310 Personal history of (healed) osteoporosis fracture

Group 2

(458 Codes)
Group 2 Paragraph

The following ICD-10-CM codes support medical necessity and provide limited coverage for CPT/HCPCS codes 0554T, 0555T, 0556T, 0557T, 0558T, 76977, 77078, 77081, G0130:

It is the provider’s responsibility to select codes carried out to the highest level of specificity and selected from the ICD-10-CM code book appropriate to the year in which the service is rendered for the claim(s) submitted.

Group 2 Codes
CodeDescription
E21.0 Primary hyperparathyroidism
E21.1 Secondary hyperparathyroidism, not elsewhere classified
E21.2 Other hyperparathyroidism
E21.3 Hyperparathyroidism, unspecified
E23.0 Hypopituitarism
E28.310 Symptomatic premature menopause
E28.319 Asymptomatic premature menopause
E28.39 Other primary ovarian failure
E34.2 Ectopic hormone secretion, not elsewhere classified
E89.40 Asymptomatic postprocedural ovarian failure
E89.41 Symptomatic postprocedural ovarian failure
M48.40XA Fatigue fracture of vertebra, site unspecified, initial encounter for fracture
M48.41XA Fatigue fracture of vertebra, occipito-atlanto-axial region, initial encounter for fracture
M48.42XA Fatigue fracture of vertebra, cervical region, initial encounter for fracture
M48.43XA Fatigue fracture of vertebra, cervicothoracic region, initial encounter for fracture
M48.44XA Fatigue fracture of vertebra, thoracic region, initial encounter for fracture
M48.45XA Fatigue fracture of vertebra, thoracolumbar region, initial encounter for fracture
M48.46XA Fatigue fracture of vertebra, lumbar region, initial encounter for fracture
M48.47XA Fatigue fracture of vertebra, lumbosacral region, initial encounter for fracture
M48.48XA Fatigue fracture of vertebra, sacral and sacrococcygeal region, initial encounter for fracture
M48.50XA Collapsed vertebra, not elsewhere classified, site unspecified, initial encounter for fracture
M48.51XA Collapsed vertebra, not elsewhere classified, occipito-atlanto-axial region, initial encounter for fracture
M48.52XA Collapsed vertebra, not elsewhere classified, cervical region, initial encounter for fracture
M48.53XA Collapsed vertebra, not elsewhere classified, cervicothoracic region, initial encounter for fracture
M48.54XA Collapsed vertebra, not elsewhere classified, thoracic region, initial encounter for fracture
M48.55XA Collapsed vertebra, not elsewhere classified, thoracolumbar region, initial encounter for fracture
M48.56XA Collapsed vertebra, not elsewhere classified, lumbar region, initial encounter for fracture
M48.57XA Collapsed vertebra, not elsewhere classified, lumbosacral region, initial encounter for fracture
M48.58XA Collapsed vertebra, not elsewhere classified, sacral and sacrococcygeal region, initial encounter for fracture
M80.08XA Age-related osteoporosis with current pathological fracture, vertebra(e), initial encounter for fracture
M80.88XA Other osteoporosis with current pathological fracture, vertebra(e), initial encounter for fracture
M84.58XA Pathological fracture in neoplastic disease, other specified site, initial encounter for fracture
M84.68XA Pathological fracture in other disease, other site, initial encounter for fracture
M84.751A Incomplete atypical femoral fracture, right leg, initial encounter for fracture
M84.752A Incomplete atypical femoral fracture, left leg, initial encounter for fracture
M84.754A Complete transverse atypical femoral fracture, right leg, initial encounter for fracture
M84.755A Complete transverse atypical femoral fracture, left leg, initial encounter for fracture
M84.757A Complete oblique atypical femoral fracture, right leg, initial encounter for fracture
M84.758A Complete oblique atypical femoral fracture, left leg, initial encounter for fracture
N95.1 Menopausal and female climacteric states
N95.8 Other specified menopausal and perimenopausal disorders
N95.9 Unspecified menopausal and perimenopausal disorder
Q78.0 Osteogenesis imperfecta
Q96.0 Karyotype 45, X
Q96.1 Karyotype 46, X iso (Xq)
Q96.2 Karyotype 46, X with abnormal sex chromosome, except iso (Xq)
Q96.3 Mosaicism, 45, X/46, XX or XY
Q96.4 Mosaicism, 45, X/other cell line(s) with abnormal sex chromosome
Q96.8 Other variants of Turner's syndrome
Q96.9 Turner's syndrome, unspecified
S12.000A Unspecified displaced fracture of first cervical vertebra, initial encounter for closed fracture
S12.000B Unspecified displaced fracture of first cervical vertebra, initial encounter for open fracture
S12.001A Unspecified nondisplaced fracture of first cervical vertebra, initial encounter for closed fracture
S12.001B Unspecified nondisplaced fracture of first cervical vertebra, initial encounter for open fracture
S12.01XA Stable burst fracture of first cervical vertebra, initial encounter for closed fracture
S12.01XB Stable burst fracture of first cervical vertebra, initial encounter for open fracture
S12.02XA Unstable burst fracture of first cervical vertebra, initial encounter for closed fracture
S12.02XB Unstable burst fracture of first cervical vertebra, initial encounter for open fracture
S12.030A Displaced posterior arch fracture of first cervical vertebra, initial encounter for closed fracture
S12.030B Displaced posterior arch fracture of first cervical vertebra, initial encounter for open fracture
S12.031A Nondisplaced posterior arch fracture of first cervical vertebra, initial encounter for closed fracture
S12.031B Nondisplaced posterior arch fracture of first cervical vertebra, initial encounter for open fracture
S12.040A Displaced lateral mass fracture of first cervical vertebra, initial encounter for closed fracture
S12.040B Displaced lateral mass fracture of first cervical vertebra, initial encounter for open fracture
S12.041A Nondisplaced lateral mass fracture of first cervical vertebra, initial encounter for closed fracture
S12.041B Nondisplaced lateral mass fracture of first cervical vertebra, initial encounter for open fracture
S12.090A Other displaced fracture of first cervical vertebra, initial encounter for closed fracture
S12.090B Other displaced fracture of first cervical vertebra, initial encounter for open fracture
S12.091A Other nondisplaced fracture of first cervical vertebra, initial encounter for closed fracture
S12.091B Other nondisplaced fracture of first cervical vertebra, initial encounter for open fracture
S12.100A Unspecified displaced fracture of second cervical vertebra, initial encounter for closed fracture
S12.100B Unspecified displaced fracture of second cervical vertebra, initial encounter for open fracture
S12.101A Unspecified nondisplaced fracture of second cervical vertebra, initial encounter for closed fracture
S12.101B Unspecified nondisplaced fracture of second cervical vertebra, initial encounter for open fracture
S12.110A Anterior displaced Type II dens fracture, initial encounter for closed fracture
S12.110B Anterior displaced Type II dens fracture, initial encounter for open fracture
S12.111A Posterior displaced Type II dens fracture, initial encounter for closed fracture
S12.111B Posterior displaced Type II dens fracture, initial encounter for open fracture
S12.112A Nondisplaced Type II dens fracture, initial encounter for closed fracture
S12.112B Nondisplaced Type II dens fracture, initial encounter for open fracture
S12.120A Other displaced dens fracture, initial encounter for closed fracture
S12.120B Other displaced dens fracture, initial encounter for open fracture
S12.121A Other nondisplaced dens fracture, initial encounter for closed fracture
S12.121B Other nondisplaced dens fracture, initial encounter for open fracture
S12.130A Unspecified traumatic displaced spondylolisthesis of second cervical vertebra, initial encounter for closed fracture
S12.130B Unspecified traumatic displaced spondylolisthesis of second cervical vertebra, initial encounter for open fracture
S12.131A Unspecified traumatic nondisplaced spondylolisthesis of second cervical vertebra, initial encounter for closed fracture
S12.131B Unspecified traumatic nondisplaced spondylolisthesis of second cervical vertebra, initial encounter for open fracture
S12.14XA Type III traumatic spondylolisthesis of second cervical vertebra, initial encounter for closed fracture
S12.14XB Type III traumatic spondylolisthesis of second cervical vertebra, initial encounter for open fracture
S12.150A Other traumatic displaced spondylolisthesis of second cervical vertebra, initial encounter for closed fracture
S12.150B Other traumatic displaced spondylolisthesis of second cervical vertebra, initial encounter for open fracture
S12.151A Other traumatic nondisplaced spondylolisthesis of second cervical vertebra, initial encounter for closed fracture
S12.151B Other traumatic nondisplaced spondylolisthesis of second cervical vertebra, initial encounter for open fracture
S12.190A Other displaced fracture of second cervical vertebra, initial encounter for closed fracture
S12.190B Other displaced fracture of second cervical vertebra, initial encounter for open fracture
S12.191A Other nondisplaced fracture of second cervical vertebra, initial encounter for closed fracture
S12.191B Other nondisplaced fracture of second cervical vertebra, initial encounter for open fracture
S12.200A Unspecified displaced fracture of third cervical vertebra, initial encounter for closed fracture
S12.200B Unspecified displaced fracture of third cervical vertebra, initial encounter for open fracture
S12.201A Unspecified nondisplaced fracture of third cervical vertebra, initial encounter for closed fracture
S12.201B Unspecified nondisplaced fracture of third cervical vertebra, initial encounter for open fracture
S12.230A Unspecified traumatic displaced spondylolisthesis of third cervical vertebra, initial encounter for closed fracture
S12.230B Unspecified traumatic displaced spondylolisthesis of third cervical vertebra, initial encounter for open fracture
S12.231A Unspecified traumatic nondisplaced spondylolisthesis of third cervical vertebra, initial encounter for closed fracture
S12.231B Unspecified traumatic nondisplaced spondylolisthesis of third cervical vertebra, initial encounter for open fracture
S12.24XA Type III traumatic spondylolisthesis of third cervical vertebra, initial encounter for closed fracture
S12.24XB Type III traumatic spondylolisthesis of third cervical vertebra, initial encounter for open fracture
S12.250A Other traumatic displaced spondylolisthesis of third cervical vertebra, initial encounter for closed fracture
S12.250B Other traumatic displaced spondylolisthesis of third cervical vertebra, initial encounter for open fracture
S12.251A Other traumatic nondisplaced spondylolisthesis of third cervical vertebra, initial encounter for closed fracture
S12.251B Other traumatic nondisplaced spondylolisthesis of third cervical vertebra, initial encounter for open fracture
S12.290A Other displaced fracture of third cervical vertebra, initial encounter for closed fracture
S12.290B Other displaced fracture of third cervical vertebra, initial encounter for open fracture
S12.291A Other nondisplaced fracture of third cervical vertebra, initial encounter for closed fracture
S12.291B Other nondisplaced fracture of third cervical vertebra, initial encounter for open fracture
S12.300A Unspecified displaced fracture of fourth cervical vertebra, initial encounter for closed fracture
S12.300B Unspecified displaced fracture of fourth cervical vertebra, initial encounter for open fracture
S12.301A Unspecified nondisplaced fracture of fourth cervical vertebra, initial encounter for closed fracture
S12.301B Unspecified nondisplaced fracture of fourth cervical vertebra, initial encounter for open fracture
S12.330A Unspecified traumatic displaced spondylolisthesis of fourth cervical vertebra, initial encounter for closed fracture
S12.330B Unspecified traumatic displaced spondylolisthesis of fourth cervical vertebra, initial encounter for open fracture
S12.331A Unspecified traumatic nondisplaced spondylolisthesis of fourth cervical vertebra, initial encounter for closed fracture
S12.331B Unspecified traumatic nondisplaced spondylolisthesis of fourth cervical vertebra, initial encounter for open fracture
S12.34XA Type III traumatic spondylolisthesis of fourth cervical vertebra, initial encounter for closed fracture
S12.34XB Type III traumatic spondylolisthesis of fourth cervical vertebra, initial encounter for open fracture
S12.350A Other traumatic displaced spondylolisthesis of fourth cervical vertebra, initial encounter for closed fracture
S12.350B Other traumatic displaced spondylolisthesis of fourth cervical vertebra, initial encounter for open fracture
S12.351A Other traumatic nondisplaced spondylolisthesis of fourth cervical vertebra, initial encounter for closed fracture
S12.351B Other traumatic nondisplaced spondylolisthesis of fourth cervical vertebra, initial encounter for open fracture
S12.390A Other displaced fracture of fourth cervical vertebra, initial encounter for closed fracture
S12.390B Other displaced fracture of fourth cervical vertebra, initial encounter for open fracture
S12.391A Other nondisplaced fracture of fourth cervical vertebra, initial encounter for closed fracture
S12.391B Other nondisplaced fracture of fourth cervical vertebra, initial encounter for open fracture
S12.400A Unspecified displaced fracture of fifth cervical vertebra, initial encounter for closed fracture
S12.400B Unspecified displaced fracture of fifth cervical vertebra, initial encounter for open fracture
S12.401A Unspecified nondisplaced fracture of fifth cervical vertebra, initial encounter for closed fracture
S12.401B Unspecified nondisplaced fracture of fifth cervical vertebra, initial encounter for open fracture
S12.430A Unspecified traumatic displaced spondylolisthesis of fifth cervical vertebra, initial encounter for closed fracture
S12.430B Unspecified traumatic displaced spondylolisthesis of fifth cervical vertebra, initial encounter for open fracture
S12.431A Unspecified traumatic nondisplaced spondylolisthesis of fifth cervical vertebra, initial encounter for closed fracture
S12.431B Unspecified traumatic nondisplaced spondylolisthesis of fifth cervical vertebra, initial encounter for open fracture
S12.44XA Type III traumatic spondylolisthesis of fifth cervical vertebra, initial encounter for closed fracture
S12.44XB Type III traumatic spondylolisthesis of fifth cervical vertebra, initial encounter for open fracture
S12.450A Other traumatic displaced spondylolisthesis of fifth cervical vertebra, initial encounter for closed fracture
S12.450B Other traumatic displaced spondylolisthesis of fifth cervical vertebra, initial encounter for open fracture
S12.451A Other traumatic nondisplaced spondylolisthesis of fifth cervical vertebra, initial encounter for closed fracture
S12.451B Other traumatic nondisplaced spondylolisthesis of fifth cervical vertebra, initial encounter for open fracture
S12.490A Other displaced fracture of fifth cervical vertebra, initial encounter for closed fracture
S12.490B Other displaced fracture of fifth cervical vertebra, initial encounter for open fracture
S12.491A Other nondisplaced fracture of fifth cervical vertebra, initial encounter for closed fracture
S12.491B Other nondisplaced fracture of fifth cervical vertebra, initial encounter for open fracture
S12.500A Unspecified displaced fracture of sixth cervical vertebra, initial encounter for closed fracture
S12.500B Unspecified displaced fracture of sixth cervical vertebra, initial encounter for open fracture
S12.501A Unspecified nondisplaced fracture of sixth cervical vertebra, initial encounter for closed fracture
S12.501B Unspecified nondisplaced fracture of sixth cervical vertebra, initial encounter for open fracture
S12.530A Unspecified traumatic displaced spondylolisthesis of sixth cervical vertebra, initial encounter for closed fracture
S12.530B Unspecified traumatic displaced spondylolisthesis of sixth cervical vertebra, initial encounter for open fracture
S12.531A Unspecified traumatic nondisplaced spondylolisthesis of sixth cervical vertebra, initial encounter for closed fracture
S12.531B Unspecified traumatic nondisplaced spondylolisthesis of sixth cervical vertebra, initial encounter for open fracture
S12.54XA Type III traumatic spondylolisthesis of sixth cervical vertebra, initial encounter for closed fracture
S12.54XB Type III traumatic spondylolisthesis of sixth cervical vertebra, initial encounter for open fracture
S12.550A Other traumatic displaced spondylolisthesis of sixth cervical vertebra, initial encounter for closed fracture
S12.550B Other traumatic displaced spondylolisthesis of sixth cervical vertebra, initial encounter for open fracture
S12.551A Other traumatic nondisplaced spondylolisthesis of sixth cervical vertebra, initial encounter for closed fracture
S12.551B Other traumatic nondisplaced spondylolisthesis of sixth cervical vertebra, initial encounter for open fracture
S12.590A Other displaced fracture of sixth cervical vertebra, initial encounter for closed fracture
S12.590B Other displaced fracture of sixth cervical vertebra, initial encounter for open fracture
S12.591A Other nondisplaced fracture of sixth cervical vertebra, initial encounter for closed fracture
S12.591B Other nondisplaced fracture of sixth cervical vertebra, initial encounter for open fracture
S12.600A Unspecified displaced fracture of seventh cervical vertebra, initial encounter for closed fracture
S12.600B Unspecified displaced fracture of seventh cervical vertebra, initial encounter for open fracture
S12.601A Unspecified nondisplaced fracture of seventh cervical vertebra, initial encounter for closed fracture
S12.601B Unspecified nondisplaced fracture of seventh cervical vertebra, initial encounter for open fracture
S12.630A Unspecified traumatic displaced spondylolisthesis of seventh cervical vertebra, initial encounter for closed fracture
S12.630B Unspecified traumatic displaced spondylolisthesis of seventh cervical vertebra, initial encounter for open fracture
S12.631A Unspecified traumatic nondisplaced spondylolisthesis of seventh cervical vertebra, initial encounter for closed fracture
S12.631B Unspecified traumatic nondisplaced spondylolisthesis of seventh cervical vertebra, initial encounter for open fracture
S12.64XA Type III traumatic spondylolisthesis of seventh cervical vertebra, initial encounter for closed fracture
S12.64XB Type III traumatic spondylolisthesis of seventh cervical vertebra, initial encounter for open fracture
S12.650A Other traumatic displaced spondylolisthesis of seventh cervical vertebra, initial encounter for closed fracture
S12.650B Other traumatic displaced spondylolisthesis of seventh cervical vertebra, initial encounter for open fracture
S12.651A Other traumatic nondisplaced spondylolisthesis of seventh cervical vertebra, initial encounter for closed fracture
S12.651B Other traumatic nondisplaced spondylolisthesis of seventh cervical vertebra, initial encounter for open fracture
S12.690A Other displaced fracture of seventh cervical vertebra, initial encounter for closed fracture
S12.690B Other displaced fracture of seventh cervical vertebra, initial encounter for open fracture
S12.691A Other nondisplaced fracture of seventh cervical vertebra, initial encounter for closed fracture
S12.691B Other nondisplaced fracture of seventh cervical vertebra, initial encounter for open fracture
S12.9XXA Fracture of neck, unspecified, initial encounter
S14.101A Unspecified injury at C1 level of cervical spinal cord, initial encounter
S14.102A Unspecified injury at C2 level of cervical spinal cord, initial encounter
S14.103A Unspecified injury at C3 level of cervical spinal cord, initial encounter
S14.104A Unspecified injury at C4 level of cervical spinal cord, initial encounter
S14.105A Unspecified injury at C5 level of cervical spinal cord, initial encounter
S14.106A Unspecified injury at C6 level of cervical spinal cord, initial encounter
S14.107A Unspecified injury at C7 level of cervical spinal cord, initial encounter
S14.109A Unspecified injury at unspecified level of cervical spinal cord, initial encounter
S14.111A Complete lesion at C1 level of cervical spinal cord, initial encounter
S14.112A Complete lesion at C2 level of cervical spinal cord, initial encounter
S14.113A Complete lesion at C3 level of cervical spinal cord, initial encounter
S14.114A Complete lesion at C4 level of cervical spinal cord, initial encounter
S14.115A Complete lesion at C5 level of cervical spinal cord, initial encounter
S14.116A Complete lesion at C6 level of cervical spinal cord, initial encounter
S14.117A Complete lesion at C7 level of cervical spinal cord, initial encounter
S14.121A Central cord syndrome at C1 level of cervical spinal cord, initial encounter
S14.122A Central cord syndrome at C2 level of cervical spinal cord, initial encounter
S14.123A Central cord syndrome at C3 level of cervical spinal cord, initial encounter
S14.124A Central cord syndrome at C4 level of cervical spinal cord, initial encounter
S14.125A Central cord syndrome at C5 level of cervical spinal cord, initial encounter
S14.126A Central cord syndrome at C6 level of cervical spinal cord, initial encounter
S14.127A Central cord syndrome at C7 level of cervical spinal cord, initial encounter
S14.131A Anterior cord syndrome at C1 level of cervical spinal cord, initial encounter
S14.132A Anterior cord syndrome at C2 level of cervical spinal cord, initial encounter
S14.133A Anterior cord syndrome at C3 level of cervical spinal cord, initial encounter
S14.134A Anterior cord syndrome at C4 level of cervical spinal cord, initial encounter
S14.135A Anterior cord syndrome at C5 level of cervical spinal cord, initial encounter
S14.136A Anterior cord syndrome at C6 level of cervical spinal cord, initial encounter
S14.137A Anterior cord syndrome at C7 level of cervical spinal cord, initial encounter
S14.151A Other incomplete lesion at C1 level of cervical spinal cord, initial encounter
S14.152A Other incomplete lesion at C2 level of cervical spinal cord, initial encounter
S14.153A Other incomplete lesion at C3 level of cervical spinal cord, initial encounter
S14.154A Other incomplete lesion at C4 level of cervical spinal cord, initial encounter
S14.155A Other incomplete lesion at C5 level of cervical spinal cord, initial encounter
S14.156A Other incomplete lesion at C6 level of cervical spinal cord, initial encounter
S14.157A Other incomplete lesion at C7 level of cervical spinal cord, initial encounter
S22.000A Wedge compression fracture of unspecified thoracic vertebra, initial encounter for closed fracture
S22.000B Wedge compression fracture of unspecified thoracic vertebra, initial encounter for open fracture
S22.001A Stable burst fracture of unspecified thoracic vertebra, initial encounter for closed fracture
S22.001B Stable burst fracture of unspecified thoracic vertebra, initial encounter for open fracture
S22.002A Unstable burst fracture of unspecified thoracic vertebra, initial encounter for closed fracture
S22.002B Unstable burst fracture of unspecified thoracic vertebra, initial encounter for open fracture
S22.008A Other fracture of unspecified thoracic vertebra, initial encounter for closed fracture
S22.008B Other fracture of unspecified thoracic vertebra, initial encounter for open fracture
S22.009A Unspecified fracture of unspecified thoracic vertebra, initial encounter for closed fracture
S22.009B Unspecified fracture of unspecified thoracic vertebra, initial encounter for open fracture
S22.010A Wedge compression fracture of first thoracic vertebra, initial encounter for closed fracture
S22.010B Wedge compression fracture of first thoracic vertebra, initial encounter for open fracture
S22.011A Stable burst fracture of first thoracic vertebra, initial encounter for closed fracture
S22.011B Stable burst fracture of first thoracic vertebra, initial encounter for open fracture
S22.012A Unstable burst fracture of first thoracic vertebra, initial encounter for closed fracture
S22.012B Unstable burst fracture of first thoracic vertebra, initial encounter for open fracture
S22.018A Other fracture of first thoracic vertebra, initial encounter for closed fracture
S22.018B Other fracture of first thoracic vertebra, initial encounter for open fracture
S22.019A Unspecified fracture of first thoracic vertebra, initial encounter for closed fracture
S22.019B Unspecified fracture of first thoracic vertebra, initial encounter for open fracture
S22.020A Wedge compression fracture of second thoracic vertebra, initial encounter for closed fracture
S22.020B Wedge compression fracture of second thoracic vertebra, initial encounter for open fracture
S22.021A Stable burst fracture of second thoracic vertebra, initial encounter for closed fracture
S22.021B Stable burst fracture of second thoracic vertebra, initial encounter for open fracture
S22.022A Unstable burst fracture of second thoracic vertebra, initial encounter for closed fracture
S22.022B Unstable burst fracture of second thoracic vertebra, initial encounter for open fracture
S22.028A Other fracture of second thoracic vertebra, initial encounter for closed fracture
S22.028B Other fracture of second thoracic vertebra, initial encounter for open fracture
S22.029A Unspecified fracture of second thoracic vertebra, initial encounter for closed fracture
S22.029B Unspecified fracture of second thoracic vertebra, initial encounter for open fracture
S22.030A Wedge compression fracture of third thoracic vertebra, initial encounter for closed fracture
S22.030B Wedge compression fracture of third thoracic vertebra, initial encounter for open fracture
S22.031A Stable burst fracture of third thoracic vertebra, initial encounter for closed fracture
S22.031B Stable burst fracture of third thoracic vertebra, initial encounter for open fracture
S22.032A Unstable burst fracture of third thoracic vertebra, initial encounter for closed fracture
S22.032B Unstable burst fracture of third thoracic vertebra, initial encounter for open fracture
S22.038A Other fracture of third thoracic vertebra, initial encounter for closed fracture
S22.038B Other fracture of third thoracic vertebra, initial encounter for open fracture
S22.039A Unspecified fracture of third thoracic vertebra, initial encounter for closed fracture
S22.039B Unspecified fracture of third thoracic vertebra, initial encounter for open fracture
S22.040A Wedge compression fracture of fourth thoracic vertebra, initial encounter for closed fracture
S22.040B Wedge compression fracture of fourth thoracic vertebra, initial encounter for open fracture
S22.041A Stable burst fracture of fourth thoracic vertebra, initial encounter for closed fracture
S22.041B Stable burst fracture of fourth thoracic vertebra, initial encounter for open fracture
S22.042A Unstable burst fracture of fourth thoracic vertebra, initial encounter for closed fracture
S22.042B Unstable burst fracture of fourth thoracic vertebra, initial encounter for open fracture
S22.048A Other fracture of fourth thoracic vertebra, initial encounter for closed fracture
S22.048B Other fracture of fourth thoracic vertebra, initial encounter for open fracture
S22.049A Unspecified fracture of fourth thoracic vertebra, initial encounter for closed fracture
S22.049B Unspecified fracture of fourth thoracic vertebra, initial encounter for open fracture
S22.050A Wedge compression fracture of T5-T6 vertebra, initial encounter for closed fracture
S22.050B Wedge compression fracture of T5-T6 vertebra, initial encounter for open fracture
S22.051A Stable burst fracture of T5-T6 vertebra, initial encounter for closed fracture
S22.051B Stable burst fracture of T5-T6 vertebra, initial encounter for open fracture
S22.052A Unstable burst fracture of T5-T6 vertebra, initial encounter for closed fracture
S22.052B Unstable burst fracture of T5-T6 vertebra, initial encounter for open fracture
S22.058A Other fracture of T5-T6 vertebra, initial encounter for closed fracture
S22.058B Other fracture of T5-T6 vertebra, initial encounter for open fracture
S22.059A Unspecified fracture of T5-T6 vertebra, initial encounter for closed fracture
S22.059B Unspecified fracture of T5-T6 vertebra, initial encounter for open fracture
S22.060A Wedge compression fracture of T7-T8 vertebra, initial encounter for closed fracture
S22.060B Wedge compression fracture of T7-T8 vertebra, initial encounter for open fracture
S22.061A Stable burst fracture of T7-T8 vertebra, initial encounter for closed fracture
S22.061B Stable burst fracture of T7-T8 vertebra, initial encounter for open fracture
S22.062A Unstable burst fracture of T7-T8 vertebra, initial encounter for closed fracture
S22.062B Unstable burst fracture of T7-T8 vertebra, initial encounter for open fracture
S22.068A Other fracture of T7-T8 thoracic vertebra, initial encounter for closed fracture
S22.068B Other fracture of T7-T8 thoracic vertebra, initial encounter for open fracture
S22.069A Unspecified fracture of T7-T8 vertebra, initial encounter for closed fracture
S22.069B Unspecified fracture of T7-T8 vertebra, initial encounter for open fracture
S22.070A Wedge compression fracture of T9-T10 vertebra, initial encounter for closed fracture
S22.070B Wedge compression fracture of T9-T10 vertebra, initial encounter for open fracture
S22.071A Stable burst fracture of T9-T10 vertebra, initial encounter for closed fracture
S22.071B Stable burst fracture of T9-T10 vertebra, initial encounter for open fracture
S22.072A Unstable burst fracture of T9-T10 vertebra, initial encounter for closed fracture
S22.072B Unstable burst fracture of T9-T10 vertebra, initial encounter for open fracture
S22.078A Other fracture of T9-T10 vertebra, initial encounter for closed fracture
S22.078B Other fracture of T9-T10 vertebra, initial encounter for open fracture
S22.079A Unspecified fracture of T9-T10 vertebra, initial encounter for closed fracture
S22.079B Unspecified fracture of T9-T10 vertebra, initial encounter for open fracture
S22.080A Wedge compression fracture of T11-T12 vertebra, initial encounter for closed fracture
S22.080B Wedge compression fracture of T11-T12 vertebra, initial encounter for open fracture
S22.081A Stable burst fracture of T11-T12 vertebra, initial encounter for closed fracture
S22.081B Stable burst fracture of T11-T12 vertebra, initial encounter for open fracture
S22.082A Unstable burst fracture of T11-T12 vertebra, initial encounter for closed fracture
S22.082B Unstable burst fracture of T11-T12 vertebra, initial encounter for open fracture
S22.088A Other fracture of T11-T12 vertebra, initial encounter for closed fracture
S22.088B Other fracture of T11-T12 vertebra, initial encounter for open fracture
S22.089A Unspecified fracture of T11-T12 vertebra, initial encounter for closed fracture
S22.089B Unspecified fracture of T11-T12 vertebra, initial encounter for open fracture
S24.101A Unspecified injury at T1 level of thoracic spinal cord, initial encounter
S24.102A Unspecified injury at T2-T6 level of thoracic spinal cord, initial encounter
S24.103A Unspecified injury at T7-T10 level of thoracic spinal cord, initial encounter
S24.104A Unspecified injury at T11-T12 level of thoracic spinal cord, initial encounter
S24.109A Unspecified injury at unspecified level of thoracic spinal cord, initial encounter
S24.111A Complete lesion at T1 level of thoracic spinal cord, initial encounter
S24.112A Complete lesion at T2-T6 level of thoracic spinal cord, initial encounter
S24.113A Complete lesion at T7-T10 level of thoracic spinal cord, initial encounter
S24.114A Complete lesion at T11-T12 level of thoracic spinal cord, initial encounter
S24.131A Anterior cord syndrome at T1 level of thoracic spinal cord, initial encounter
S24.132A Anterior cord syndrome at T2-T6 level of thoracic spinal cord, initial encounter
S24.133A Anterior cord syndrome at T7-T10 level of thoracic spinal cord, initial encounter
S24.134A Anterior cord syndrome at T11-T12 level of thoracic spinal cord, initial encounter
S24.151A Other incomplete lesion at T1 level of thoracic spinal cord, initial encounter
S24.152A Other incomplete lesion at T2-T6 level of thoracic spinal cord, initial encounter
S24.153A Other incomplete lesion at T7-T10 level of thoracic spinal cord, initial encounter
S24.154A Other incomplete lesion at T11-T12 level of thoracic spinal cord, initial encounter
S32.000A Wedge compression fracture of unspecified lumbar vertebra, initial encounter for closed fracture
S32.000B Wedge compression fracture of unspecified lumbar vertebra, initial encounter for open fracture
S32.001A Stable burst fracture of unspecified lumbar vertebra, initial encounter for closed fracture
S32.001B Stable burst fracture of unspecified lumbar vertebra, initial encounter for open fracture
S32.002A Unstable burst fracture of unspecified lumbar vertebra, initial encounter for closed fracture
S32.002B Unstable burst fracture of unspecified lumbar vertebra, initial encounter for open fracture
S32.008A Other fracture of unspecified lumbar vertebra, initial encounter for closed fracture
S32.008B Other fracture of unspecified lumbar vertebra, initial encounter for open fracture
S32.009A Unspecified fracture of unspecified lumbar vertebra, initial encounter for closed fracture
S32.009B Unspecified fracture of unspecified lumbar vertebra, initial encounter for open fracture
S32.010A Wedge compression fracture of first lumbar vertebra, initial encounter for closed fracture
S32.010B Wedge compression fracture of first lumbar vertebra, initial encounter for open fracture
S32.011A Stable burst fracture of first lumbar vertebra, initial encounter for closed fracture
S32.011B Stable burst fracture of first lumbar vertebra, initial encounter for open fracture
S32.012A Unstable burst fracture of first lumbar vertebra, initial encounter for closed fracture
S32.012B Unstable burst fracture of first lumbar vertebra, initial encounter for open fracture
S32.018A Other fracture of first lumbar vertebra, initial encounter for closed fracture
S32.018B Other fracture of first lumbar vertebra, initial encounter for open fracture
S32.019A Unspecified fracture of first lumbar vertebra, initial encounter for closed fracture
S32.019B Unspecified fracture of first lumbar vertebra, initial encounter for open fracture
S32.020A Wedge compression fracture of second lumbar vertebra, initial encounter for closed fracture
S32.020B Wedge compression fracture of second lumbar vertebra, initial encounter for open fracture
S32.021A Stable burst fracture of second lumbar vertebra, initial encounter for closed fracture
S32.021B Stable burst fracture of second lumbar vertebra, initial encounter for open fracture
S32.022A Unstable burst fracture of second lumbar vertebra, initial encounter for closed fracture
S32.022B Unstable burst fracture of second lumbar vertebra, initial encounter for open fracture
S32.028A Other fracture of second lumbar vertebra, initial encounter for closed fracture
S32.028B Other fracture of second lumbar vertebra, initial encounter for open fracture
S32.029A Unspecified fracture of second lumbar vertebra, initial encounter for closed fracture
S32.029B Unspecified fracture of second lumbar vertebra, initial encounter for open fracture
S32.030A Wedge compression fracture of third lumbar vertebra, initial encounter for closed fracture
S32.030B Wedge compression fracture of third lumbar vertebra, initial encounter for open fracture
S32.031A Stable burst fracture of third lumbar vertebra, initial encounter for closed fracture
S32.031B Stable burst fracture of third lumbar vertebra, initial encounter for open fracture
S32.032A Unstable burst fracture of third lumbar vertebra, initial encounter for closed fracture
S32.032B Unstable burst fracture of third lumbar vertebra, initial encounter for open fracture
S32.038A Other fracture of third lumbar vertebra, initial encounter for closed fracture
S32.038B Other fracture of third lumbar vertebra, initial encounter for open fracture
S32.039A Unspecified fracture of third lumbar vertebra, initial encounter for closed fracture
S32.039B Unspecified fracture of third lumbar vertebra, initial encounter for open fracture
S32.040A Wedge compression fracture of fourth lumbar vertebra, initial encounter for closed fracture
S32.040B Wedge compression fracture of fourth lumbar vertebra, initial encounter for open fracture
S32.041A Stable burst fracture of fourth lumbar vertebra, initial encounter for closed fracture
S32.041B Stable burst fracture of fourth lumbar vertebra, initial encounter for open fracture
S32.042A Unstable burst fracture of fourth lumbar vertebra, initial encounter for closed fracture
S32.042B Unstable burst fracture of fourth lumbar vertebra, initial encounter for open fracture
S32.048A Other fracture of fourth lumbar vertebra, initial encounter for closed fracture
S32.048B Other fracture of fourth lumbar vertebra, initial encounter for open fracture
S32.049A Unspecified fracture of fourth lumbar vertebra, initial encounter for closed fracture
S32.049B Unspecified fracture of fourth lumbar vertebra, initial encounter for open fracture
S32.050A Wedge compression fracture of fifth lumbar vertebra, initial encounter for closed fracture
S32.050B Wedge compression fracture of fifth lumbar vertebra, initial encounter for open fracture
S32.051A Stable burst fracture of fifth lumbar vertebra, initial encounter for closed fracture
S32.051B Stable burst fracture of fifth lumbar vertebra, initial encounter for open fracture
S32.052A Unstable burst fracture of fifth lumbar vertebra, initial encounter for closed fracture
S32.052B Unstable burst fracture of fifth lumbar vertebra, initial encounter for open fracture
S32.058A Other fracture of fifth lumbar vertebra, initial encounter for closed fracture
S32.058B Other fracture of fifth lumbar vertebra, initial encounter for open fracture
S32.059A Unspecified fracture of fifth lumbar vertebra, initial encounter for closed fracture
S32.059B Unspecified fracture of fifth lumbar vertebra, initial encounter for open fracture
S32.10XA Unspecified fracture of sacrum, initial encounter for closed fracture
S32.10XB Unspecified fracture of sacrum, initial encounter for open fracture
S32.110A Nondisplaced Zone I fracture of sacrum, initial encounter for closed fracture
S32.110B Nondisplaced Zone I fracture of sacrum, initial encounter for open fracture
S32.111A Minimally displaced Zone I fracture of sacrum, initial encounter for closed fracture
S32.111B Minimally displaced Zone I fracture of sacrum, initial encounter for open fracture
S32.112A Severely displaced Zone I fracture of sacrum, initial encounter for closed fracture
S32.112B Severely displaced Zone I fracture of sacrum, initial encounter for open fracture
S32.119A Unspecified Zone I fracture of sacrum, initial encounter for closed fracture
S32.119B Unspecified Zone I fracture of sacrum, initial encounter for open fracture
S32.120A Nondisplaced Zone II fracture of sacrum, initial encounter for closed fracture
S32.120B Nondisplaced Zone II fracture of sacrum, initial encounter for open fracture
S32.121A Minimally displaced Zone II fracture of sacrum, initial encounter for closed fracture
S32.121B Minimally displaced Zone II fracture of sacrum, initial encounter for open fracture
S32.122A Severely displaced Zone II fracture of sacrum, initial encounter for closed fracture
S32.122B Severely displaced Zone II fracture of sacrum, initial encounter for open fracture
S32.129A Unspecified Zone II fracture of sacrum, initial encounter for closed fracture
S32.129B Unspecified Zone II fracture of sacrum, initial encounter for open fracture
S32.130A Nondisplaced Zone III fracture of sacrum, initial encounter for closed fracture
S32.130B Nondisplaced Zone III fracture of sacrum, initial encounter for open fracture
S32.131A Minimally displaced Zone III fracture of sacrum, initial encounter for closed fracture
S32.131B Minimally displaced Zone III fracture of sacrum, initial encounter for open fracture
S32.132A Severely displaced Zone III fracture of sacrum, initial encounter for closed fracture
S32.132B Severely displaced Zone III fracture of sacrum, initial encounter for open fracture
S32.139A Unspecified Zone III fracture of sacrum, initial encounter for closed fracture
S32.139B Unspecified Zone III fracture of sacrum, initial encounter for open fracture
S32.14XA Type 1 fracture of sacrum, initial encounter for closed fracture
S32.14XB Type 1 fracture of sacrum, initial encounter for open fracture
S32.15XA Type 2 fracture of sacrum, initial encounter for closed fracture
S32.15XB Type 2 fracture of sacrum, initial encounter for open fracture
S32.16XA Type 3 fracture of sacrum, initial encounter for closed fracture
S32.16XB Type 3 fracture of sacrum, initial encounter for open fracture
S32.17XA Type 4 fracture of sacrum, initial encounter for closed fracture
S32.17XB Type 4 fracture of sacrum, initial encounter for open fracture
S32.19XA Other fracture of sacrum, initial encounter for closed fracture
S32.19XB Other fracture of sacrum, initial encounter for open fracture
S32.2XXA Fracture of coccyx, initial encounter for closed fracture
S32.2XXB Fracture of coccyx, initial encounter for open fracture
S34.101A Unspecified injury to L1 level of lumbar spinal cord, initial encounter
S34.102A Unspecified injury to L2 level of lumbar spinal cord, initial encounter
S34.103A Unspecified injury to L3 level of lumbar spinal cord, initial encounter
S34.104A Unspecified injury to L4 level of lumbar spinal cord, initial encounter
S34.105A Unspecified injury to L5 level of lumbar spinal cord, initial encounter
S34.109A Unspecified injury to unspecified level of lumbar spinal cord, initial encounter
S34.111A Complete lesion of L1 level of lumbar spinal cord, initial encounter
S34.112A Complete lesion of L2 level of lumbar spinal cord, initial encounter
S34.113A Complete lesion of L3 level of lumbar spinal cord, initial encounter
S34.114A Complete lesion of L4 level of lumbar spinal cord, initial encounter
S34.115A Complete lesion of L5 level of lumbar spinal cord, initial encounter
S34.119A Complete lesion of unspecified level of lumbar spinal cord, initial encounter
S34.121A Incomplete lesion of L1 level of lumbar spinal cord, initial encounter
S34.122A Incomplete lesion of L2 level of lumbar spinal cord, initial encounter
S34.123A Incomplete lesion of L3 level of lumbar spinal cord, initial encounter
S34.124A Incomplete lesion of L4 level of lumbar spinal cord, initial encounter
S34.125A Incomplete lesion of L5 level of lumbar spinal cord, initial encounter
S34.129A Incomplete lesion of unspecified level of lumbar spinal cord, initial encounter
S34.131A Complete lesion of sacral spinal cord, initial encounter
S34.132A Incomplete lesion of sacral spinal cord, initial encounter
S34.139A Unspecified injury to sacral spinal cord, initial encounter
S34.3XXA Injury of cauda equina, initial encounter
Z78.0 Asymptomatic menopausal state
Z79.3 Long term (current) use of hormonal contraceptives
Z79.51 Long term (current) use of inhaled steroids
Z79.52 Long term (current) use of systemic steroids
Z79.83 Long term (current) use of bisphosphonates
Z87.310 Personal history of (healed) osteoporosis fracture

ICD-10-CM Codes that DO NOT Support Medical Necessity

Group 1

(1 Code)
Group 1 Paragraph

All those not listed under the “ICD-10 Codes that Support Medical Necessity” section of this article.

Group 1 Codes
CodeDescription
XX000 Not Applicable

Additional ICD-10 Information

N/A

Bill Type Codes

Contractors may specify Bill Types to help providers identify those Bill Types typically used to report this service. Absence of a Bill Type does not guarantee that the article does not apply to that Bill Type. Complete absence of all Bill Types indicates that coverage is not influenced by Bill Type and the article should be assumed to apply equally to all claims.

CodeDescription
999x Not Applicable

Revenue Codes

Contractors may specify Revenue Codes to help providers identify those Revenue Codes typically used to report this service. In most instances Revenue Codes are purely advisory. Unless specified in the article, services reported under other Revenue Codes are equally subject to this coverage determination. Complete absence of all Revenue Codes indicates that coverage is not influenced by Revenue Code and the article should be assumed to apply equally to all Revenue Codes.

CodeDescription
99999 Not Applicable

Other Coding Information

N/A

Revision History Information

Revision History DateRevision History NumberRevision History Explanation
03/24/2020 R4

Revision Number: 4
Publication: April 2020 Connection
LCR A/B2020-023

Explanation of Revision: Based on CR 11655 (ICD-10 and Other Coding Revisions to National Coverage Determinations [NCDs]-July 2020 Update), the “ICD-10 Codes that Support Medical Necessity/Group 1 Codes:” section of the billing and coding article was revised to add ICD-10-CM diagnosis code Z79.818 for CPT codes 77080, 77085, and 0508T. The effective date of this revision is for claims processed on or after 03/24/2020, for dates of service on or after 01/01/2020.

01/01/2020 R3

Revision Number: 3
Publication: December 2019 Connection
LCR A/B2019-083

Explanation of Revision: Based on CR 11392 (ICD-10 and Other Coding Revisions to National Coverage Determinations [NCDs]-January 2020 Update), the Billing and Coding Article was revised to remove ICD-10-CM diagnosis codes M85.9, M89.9, M94.9, and Q55.4 for CPT codes 77080, 77085, and 0508T and ICD-10-CM diagnosis codes M85.9 and Q55.4 for CPT codes 0554T, 0555T, 0556T, 0557T, 0558T, 76977, 77078, 77081, and G0130. The effective date of this revision is for dates of service on or after 01/01/2020.

09/23/2019 R2

Revision Number: 2
Publication: September 2019 Connection
LCR A/B2019-057

Explanation of Revision: Based on CR 11392 (ICD-10 and Other Coding Revisions to National Coverage Determinations [NCDs]-January 2020 Update), the Billing and Coding Article was revised to add CPT codes 0554T, 0555T, 0556T, 0557T, and 0558T to the “CPT/HCPCS Codes/Group 2 Codes:” section of the Billing and Coding Article. The effective date of this revision is for claims processed on or after 09/23/2019, for dates of service on or after 07/01/2019.

Also, based on review of the Billing and Coding Article, CMS IOM language was revised/clarified in the “CPT/HCPCS Codes/Group 1 Paragraph:” section of the Billing and Coding Article. The effective date of this revision is for dates of service on or after 09/10/2019.

06/18/2019 R1

Revision Number: 1
Publication: June 2019 Connection
LCR A/B2019-031

Explanation of Revision: Based on review of the Billing and Coding article, typographical and formatting errors were corrected. Also, NCD and IOM language was removed from the Billing and Coding article and instead the NCD IOM citation related to this language is referenced in the LCD. The effective date of this revision is based on date of service.

Associated Documents

Related Local Coverage Documents
Articles
A58041 - (MCD Archive Site)
LCDs
L36356 - Bone Mineral Density Studies
Related National Coverage Documents
NCDs
150.3 - Bone (Mineral) Density Studies
Statutory Requirements URLs
N/A
Rules and Regulations URLs
N/A
CMS Manual Explanations URLs
N/A
Other URLs
N/A
Public Versions
Updated On Effective Dates Status
03/24/2020 03/24/2020 - N/A Currently in Effect You are here
Some older versions have been archived. Please visit the MCD Archive Site to retrieve them.

Keywords

  • Bone Mass
  • Bone Mineral