LCD Reference Article Billing and Coding Article

Billing and Coding: Bone Mass Measurement

A57132

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Draft Articles are works in progress and not necessarily a reflection of the current billing and coding practices. Revisions to codes are carefully and thoroughly reviewed and are not intended to change the original intent of the LCD.

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Source Article ID
N/A
Article ID
A57132
Original ICD-9 Article ID
Not Applicable
Article Title
Billing and Coding: Bone Mass Measurement
Article Type
Billing and Coding
Original Effective Date
09/26/2019
Revision Effective Date
01/04/2024
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 2023 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 © 2023 American Dental Association. All rights reserved.

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CMS National Coverage Policy

Title XVIII of the Social Security Act (SSA):

Section 1862(a)(1)(A) excludes expenses incurred for items or services which are not reasonable and necessary
for the diagnosis or treatment of illness or injury or to improve the functioning of a malformed body member.

Section 1833(e) prohibits Medicare payment for any claim which lacks the necessary information to process
the claim.

Section 1861(r) provides the definition of a physician.

Section 1861(s)(2)(V)(15) includes bone mass measurement as a physician service.

Section 1861(rr) provides the definition of bone mass measurement.

Code of Federal Regulations:

Title IV of the Balanced Budget Act of 1997, Section 4106 includes language providing for Medicare coverage
of bone mass measurement procedures, and coverage of FDA-approved bone mass measurement techniques
and equipment for "qualified" individuals. These procedures are only covered when medically necessary.

CMS Publications:

CMS Manual System, Pub. 100-02, Medicare Benefit Policy Manual, Chapter 15:

80.5 Bone Mass Measurements (BMMs)

CMS Manual System, Pub. 100-03, Medicare National Coverage Determinations, Chapter 1:

150.3 Bone (Mineral) Density Studies (Effective January 1, 2007)

CMS Manual System, Pub. 100-04, Medicare Claims Processing Manual, Chapter 13:

140 Bone Mass Measurements (BMMs).

Article Guidance

Article Text

This article gives guidance for billing, coding, and other guidelines in relation to local coverage policy L36460-Bone Mass Measurement.

 

General Guidelines for Claims submitted to Part A or Part B MAC:

Procedure codes may be subject to National Correct Coding Initiative (NCCI) edits or OPPS packaging edits. Refer to NCCI and OPPS requirements prior to billing Medicare. For services requiring a referring/ordering physician, the name and NPI of the referring/ordering physician must be reported on the claim. A claim submitted without a valid ICD-10-CM diagnosis code will be returned to the provider as an incomplete claim under Section 1833(e) of the Social Security Act. The diagnosis code(s) must best describe the patient's condition for which the service was performed. For diagnostic tests, report the result of the test if known; otherwise the symptoms prompting the performance of the test should be reported.

 

Advance Beneficiary Notice of Non-coverage (ABN) Modifier Guidelines

An ABN may be used for services which are likely to be non-covered, whether for medical necessity or for other reasons. Refer to CMS Publication 100-04, Medicare Claims Processing Manual, Chapter 30, for complete instructions.

Effective from April 1, 2010, non-covered services should be billed with modifier –GA, -GX, -GY, or –GZ, as appropriate.

The –GA modifier (“Waiver of Liability Statement Issued as Required by Payer Policy”) should be used when physicians, practitioners, or suppliers want to indicate that they anticipate that Medicare will deny a specific service as not reasonable and necessary and they do have an ABN signed by the beneficiary on file. Modifier GA applies only when services will be denied under reasonable and necessary provisions, sections 1862(a)(1), 1862(a)(9), 1879(e), or 1879(g) of the Social Security Act. Effective April 1, 2010, Part A MAC systems will automatically deny services billed with modifier GA. An ABN, Form CMS-R-131, should be signed by the beneficiary to indicate that ‎he/she accepts responsibility for payment.‎ The -GA modifier may also be used on assigned claims when a patient refuses to sign the ABN and the latter is properly witnessed. For claims submitted to the Part A MAC, occurrence code 32 and the date of the ABN is required.

 

Modifier GX (“Notice of Liability Issued, Voluntary Under Payer Policy”) should be used when the beneficiary has signed an ABN, and a denial is anticipated based on provisions other than medical necessity, such as statutory exclusions of coverage or technical issues. An ABN is not required for these denials, but if non-covered services are reported with modifier GX, will automatically be denied services.

 

The –GZ modifier should be used when physicians, practitioners, or suppliers want to indicate that they expect that Medicare will deny an item or service as not reasonable and necessary and they have not had an ABN signed by the beneficiary. ‎If the service is statutorily non-covered, or without a benefit category, submit the ‎appropriate CPT/HCPCS code with the -GY modifier. An ABN is not required for these denials, and the limitation of liability does not apply for beneficiaries. Services with modifier GY will automatically deny.

Documentation Requirements

The patient’s medical record should include but is not limited to:

  • The assessment of the patient by the ordering provider as it relates to the complaint of the patient for that visit,
  • Relevant medical history
  • Results of pertinent tests/procedures
  • Signed and dated office visit record/operative report (Please note that all services ordered or rendered to Medicare beneficiaries must be signed.)+

 

Earlier technologies, such as single and dual photon absorptiometry ( CPT code 78350 or 78351), are no
longer used.

Limitations:

1. Tests not ordered by the physician/qualified non-physician practitioner, who is treating the beneficiary, are not reasonable and necessary.

2. Medicare reimbursement for an initial bone mass measurement may be allowed only once, regardless of
sites studied (e.g., if the spine and hip are studied, CPT code 77080 should be billed only once).

3. It is not medically necessary to perform more than one type of BMM test in any individual, unless a
DXA confirmatory test is performed as a baseline for future monitoring (see Indications #7 and #8).

4. It is not medically necessary to have both peripheral and axial BMM tests performed on the same day.

5. Medicare will not reimburse BMM tests performed by a second provider, when a test has already been
performed within the defined coverage period, as stated above, unless as confirmatory testing for future
monitoring. Beneficiaries must authorize providers to obtain prior test results. If unsuccessful efforts to
obtain prior test results from another provider are documented, new tests may be considered for
reimbursement.

6. Single and dual photon absorptiometry, CPT code 78350 and 78351, are non-covered services.

7. Bone mass measurement is not covered under the portable x-ray benefit and will be denied when
performed by a portable x-ray supplier. Transportation charges for BMM testing are not covered.

8. Bone mass measurement tests provided without an accompanying interpretation and report, as part of
the test, will be denied as not medically necessary. The report must be separate and distinct from an evaluation and management note/record.

9. CPT code 77082 is considered by Medicare to represent vertebral fracture assessment only. Because
code 77082 does not represent a bone density study, it should NOT be billed for screening. This code
may be billed when medically necessary (i.e. when a vertebral fracture assessment is required).
Symptoms should be present and documented, and it should be anticipated that the results of the test
will be used in the management of the patient.

Other Comments:

For Claims submitted to the Part A MAC: This coverage determination also applies within states outside the
primary geographic jurisdiction with facilities that have nominated CGS Administrators to process their claims.

Bill type codes only apply to providers who bill these services to the Part A MAC. Bill type codes do not apply
to physicians, other professionals and suppliers who bill these services to the carrier or Part B MAC.

Limitation of liability and refund requirements apply when denials are likely, whether based on medical
necessity or other coverage reasons. The provider/supplier must notify the beneficiary in writing, prior to
rendering the service, if the provider/supplier is aware that the test, item or procedure may not be covered by
Medicare. The limitation of liability and refund requirements do not apply when the test, item or procedure is
statutorily excluded, has no Medicare benefit category or is rendered for screening purposes.

For outpatient settings other than CORFs, references to "physicians" throughout this policy include nonphysicians,
such as nurse practitioners, clinical nurse specialists and physician assistants. Such non-physician
practitioners, with certain exceptions, may certify, order and establish the plan of care as authorized by State
law. (See Sections 1861[s][2] and 1862[a][14] of Title XVIII of the Social Security Act; 42 CFR, Sections
410.74, 410.75, 410.76 and 419.22; 58 FR 18543, April 7, 2000.)

 

Response To Comments

Number Comment Response
1
N/A

Coding Information

Bill Type Codes

Code Description
012x Hospital Inpatient (Medicare Part B only)
013x Hospital Outpatient
022x Skilled Nursing - Inpatient (Medicare Part B only)
023x Skilled Nursing - Outpatient
034x Home Health Services not under a plan of treatment
071x Clinic - Rural Health
072x Clinic - Hospital Based or Independent Renal Dialysis Center
073x Clinic - Freestanding
077x Clinic - Federally Qualified Health Center (FQHC)
085x Critical Access Hospital
N/A

Revenue Codes

Code Description
0320 Radiology - Diagnostic - General Classification
0333 Radiology - Therapeutic and/or Chemotherapy Administration - Radiation Therapy
0340 Nuclear Medicine - General Classification
0341 Nuclear Medicine - Diagnostic
0350 CT Scan - General Classification
0352 CT Scan - Body Scan
0400 Other Imaging Services - General Classification
0402 Other Imaging Services - Ultrasound
0520 Freestanding Clinic - General Classification
0521 Freestanding Clinic - Clinic Visit by Member to RHC/FQHC
0522 Freestanding Clinic - Home Visit by RHC/FQHC Practitioner
0523 Freestanding Clinic - Family Practice Clinic
0524 Freestanding Clinic - Visit by RHC/FQHC Practitioner to a Member in a SNF or Skilled Swing Bed in a Covered Part A Stay
0525 Freestanding Clinic - Visit by RHC/FQHC Practitioner to a Member in a SNF (not in a Covered Part A Stay) or NF or ICF MR or Other Residential Facility
0527 Freestanding Clinic - Visiting Nurse Service(s) to a Member's Home when in a Home Health Shortage Area
0610 Magnetic Resonance Technology (MRT) - General Classification
0612 Magnetic Resonance Technology (MRT) - MRI - Spinal Cord/Spine
0616 Magnetic Resonance Technology (MRT) - MRA - Lower Extremities
0960 Professional Fees - General Classification
0969 Professional Fees - Other Professional Fee
0972 Professional Fees - Radiology - Diagnostic
0982 Professional Fees - Outpatient Services
0983 Professional Fees - Clinic
N/A

CPT/HCPCS Codes

Group 1

(13 Codes)
Group 1 Paragraph

CPT codes 78350 and 78351 are non-covered procedures under Medicare.

Group 1 Codes
Code Description
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)
77080 DUAL-ENERGY X-RAY ABSORPTIOMETRY (DXA), BONE 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)
77085 DUAL-ENERGY X-RAY ABSORPTIOMETRY (DXA), BONE DENSITY STUDY, 1 OR MORE SITES; AXIAL SKELETON (EG, HIPS, PELVIS, SPINE), INCLUDING VERTEBRAL FRACTURE ASSESSMENT
78350 BONE DENSITY (BONE MINERAL CONTENT) STUDY, 1 OR MORE SITES; SINGLE PHOTON ABSORPTIOMETRY
78351 BONE DENSITY (BONE MINERAL CONTENT) STUDY, 1 OR MORE SITES; DUAL PHOTON ABSORPTIOMETRY, 1 OR MORE SITES
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
N/A

CPT/HCPCS Modifiers

Group 1

Group 1 Paragraph

N/A

Group 1 Codes

N/A

N/A

ICD-10-CM Codes that Support Medical Necessity

Group 1

(428 Codes)
Group 1 Paragraph

It is the responsibility of the provider to code to the highest level specified in the ICD-10-CM. The correct
use of an ICD-10-CM code listed below does not assure coverage of a service. The service must be
reasonable and necessary in the specific case and must meet the criteria specified in this determination.

 

77080

Group 1 Codes
Code Description
E21.0 Primary hyperparathyroidism
E21.3 Hyperparathyroidism, unspecified
E23.0 Hypopituitarism
E24.0 Pituitary-dependent Cushing's disease
E24.2 - E24.4 Drug-induced Cushing's syndrome - Alcohol-induced pseudo-Cushing's syndrome
E24.8 - E24.9 Other Cushing's syndrome - 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 - E89.41 Asymptomatic postprocedural ovarian failure - Symptomatic postprocedural ovarian failure
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
M80.0B1A Age-related osteoporosis with current pathological fracture, right pelvis, initial encounter for fracture
M80.0B1D Age-related osteoporosis with current pathological fracture, right pelvis, subsequent encounter for fracture with routine healing
M80.0B1G Age-related osteoporosis with current pathological fracture, right pelvis, subsequent encounter for fracture with delayed healing
M80.0B1K Age-related osteoporosis with current pathological fracture, right pelvis, subsequent encounter for fracture with nonunion
M80.0B1P Age-related osteoporosis with current pathological fracture, right pelvis, subsequent encounter for fracture with malunion
M80.0B1S Age-related osteoporosis with current pathological fracture, right pelvis, sequela
M80.0B2A Age-related osteoporosis with current pathological fracture, left pelvis, initial encounter for fracture
M80.0B2D Age-related osteoporosis with current pathological fracture, left pelvis, subsequent encounter for fracture with routine healing
M80.0B2G Age-related osteoporosis with current pathological fracture, left pelvis, subsequent encounter for fracture with delayed healing
M80.0B2K Age-related osteoporosis with current pathological fracture, left pelvis, subsequent encounter for fracture with nonunion
M80.0B2P Age-related osteoporosis with current pathological fracture, left pelvis, subsequent encounter for fracture with malunion
M80.0B2S Age-related osteoporosis with current pathological fracture, left pelvis, sequela
M80.0B9A Age-related osteoporosis with current pathological fracture, unspecified pelvis, initial encounter for fracture
M80.0B9D Age-related osteoporosis with current pathological fracture, unspecified pelvis, subsequent encounter for fracture with routine healing
M80.88XA Other osteoporosis with current pathological fracture, vertebra(e), initial encounter for fracture
M80.8B1A Other osteoporosis with current pathological fracture, right pelvis, initial encounter for fracture
M80.8B1D Other osteoporosis with current pathological fracture, right pelvis, subsequent encounter for fracture with routine healing
M80.8B1G Other osteoporosis with current pathological fracture, right pelvis, subsequent encounter for fracture with delayed healing
M80.8B1K Other osteoporosis with current pathological fracture, right pelvis, subsequent encounter for fracture with nonunion
M80.8B1P Other osteoporosis with current pathological fracture, right pelvis, subsequent encounter for fracture with malunion
M80.8B1S Other osteoporosis with current pathological fracture, right pelvis, sequela
M80.8B2A Other osteoporosis with current pathological fracture, left pelvis, initial encounter for fracture
M80.8B2D Other osteoporosis with current pathological fracture, left pelvis, subsequent encounter for fracture with routine healing
M80.8B2G Other osteoporosis with current pathological fracture, left pelvis, subsequent encounter for fracture with delayed healing
M80.8B2K Other osteoporosis with current pathological fracture, left pelvis, subsequent encounter for fracture with nonunion
M80.8B2P Other osteoporosis with current pathological fracture, left pelvis, subsequent encounter for fracture with malunion
M80.8B2S Other osteoporosis with current pathological fracture, left pelvis, sequela
M80.8B9A Other osteoporosis with current pathological fracture, unspecified pelvis, initial encounter for fracture
M80.8B9D Other osteoporosis with current pathological fracture, unspecified pelvis, subsequent encounter for fracture with routine healing
M80.8B9G Other osteoporosis with current pathological fracture, unspecified pelvis, subsequent encounter for fracture with delayed healing
M80.8B9K Other osteoporosis with current pathological fracture, unspecified pelvis, subsequent encounter for fracture with nonunion
M80.8B9P Other osteoporosis with current pathological fracture, unspecified pelvis, subsequent encounter for fracture with malunion
M80.8B9S Other osteoporosis with current pathological fracture, unspecified pelvis, sequela
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
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
N95.8 - N95.9 Other specified menopausal and perimenopausal disorders - Unspecified menopausal and perimenopausal disorder
Q78.0 Osteogenesis imperfecta
Q96.0 - Q96.4 Karyotype 45, X - Mosaicism, 45, X/other cell line(s) with abnormal sex chromosome
Q96.8 - Q96.9 Other variants of Turner's syndrome - 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
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
S22.018A 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
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
S32.139A 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
T38.0X5A Adverse effect of glucocorticoids and synthetic analogues, initial encounter
T38.0X5S Adverse effect of glucocorticoids and synthetic analogues, sequela
T50.0X5A Adverse effect of mineralocorticoids and their antagonists, initial encounter
T50.0X5S Adverse effect of mineralocorticoids and their antagonists, sequela
Z09 Encounter for follow-up examination after completed treatment for conditions other than malignant neoplasm
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
Z79.85 Long-term (current) use of injectable non-insulin antidiabetic drugs
Z90.721 Acquired absence of ovaries, unilateral
Z90.722 Acquired absence of ovaries, bilateral
Z90.79 Acquired absence of other genital organ(s)

Group 2

(412 Codes)
Group 2 Paragraph

77078, 77081, 77085, 76977, G0130, 0508T,0554T, 0555T, 0556T, 0557T, 0558T:

Group 2 Codes
Code Description
E21.0 Primary hyperparathyroidism
E21.3 Hyperparathyroidism, unspecified
E23.0 Hypopituitarism
E24.0 Pituitary-dependent Cushing's disease
E24.2 - E24.4 Drug-induced Cushing's syndrome - Alcohol-induced pseudo-Cushing's syndrome
E24.8 - E24.9 Other Cushing's syndrome - 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 - E89.41 Asymptomatic postprocedural ovarian failure - Symptomatic postprocedural ovarian failure
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
M80.8B1A Other osteoporosis with current pathological fracture, right pelvis, initial encounter for fracture
M80.8B1D Other osteoporosis with current pathological fracture, right pelvis, subsequent encounter for fracture with routine healing
M80.8B1G Other osteoporosis with current pathological fracture, right pelvis, subsequent encounter for fracture with delayed healing
M80.8B1K Other osteoporosis with current pathological fracture, right pelvis, subsequent encounter for fracture with nonunion
M80.8B1P Other osteoporosis with current pathological fracture, right pelvis, subsequent encounter for fracture with malunion
M80.8B1S Other osteoporosis with current pathological fracture, right pelvis, sequela
M80.8B2A Other osteoporosis with current pathological fracture, left pelvis, initial encounter for fracture
M80.8B2D Other osteoporosis with current pathological fracture, left pelvis, subsequent encounter for fracture with routine healing
M80.8B2G Other osteoporosis with current pathological fracture, left pelvis, subsequent encounter for fracture with delayed healing
M80.8B2K Other osteoporosis with current pathological fracture, left pelvis, subsequent encounter for fracture with nonunion
M80.8B2P Other osteoporosis with current pathological fracture, left pelvis, subsequent encounter for fracture with malunion
M80.8B2S Other osteoporosis with current pathological fracture, left pelvis, sequela
M80.8B9A Other osteoporosis with current pathological fracture, unspecified pelvis, initial encounter for fracture
M80.8B9D Other osteoporosis with current pathological fracture, unspecified pelvis, subsequent encounter for fracture with routine healing
M80.8B9G Other osteoporosis with current pathological fracture, unspecified pelvis, subsequent encounter for fracture with delayed healing
M80.8B9K Other osteoporosis with current pathological fracture, unspecified pelvis, subsequent encounter for fracture with nonunion
M80.8B9P Other osteoporosis with current pathological fracture, unspecified pelvis, subsequent encounter for fracture with malunion
M80.8B9S Other osteoporosis with current pathological fracture, unspecified pelvis, sequela
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
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
N95.8 - N95.9 Other specified menopausal and perimenopausal disorders - Unspecified menopausal and perimenopausal disorder
Q78.0 Osteogenesis imperfecta
Q96.0 - Q96.4 Karyotype 45, X - Mosaicism, 45, X/other cell line(s) with abnormal sex chromosome
Q96.8 - Q96.9 Other variants of Turner's syndrome - 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
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
S22.018A 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
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
S32.139A 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
T38.0X5A Adverse effect of glucocorticoids and synthetic analogues, initial encounter
T38.0X5S Adverse effect of glucocorticoids and synthetic analogues, sequela
T50.0X5A Adverse effect of mineralocorticoids and their antagonists, initial encounter
T50.0X5S Adverse effect of mineralocorticoids and their antagonists, sequela
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
Z79.85 Long-term (current) use of injectable non-insulin antidiabetic drugs
Z90.721 Acquired absence of ovaries, unilateral
Z90.722 Acquired absence of ovaries, bilateral
Z90.79 Acquired absence of other genital organ(s)
N/A

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

Group 1

Group 1 Paragraph

N/A

Group 1 Codes

N/A

N/A

ICD-10-PCS Codes

Group 1

Group 1 Paragraph

N/A

Group 1 Codes

N/A

N/A

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.

Code Description
012x Hospital Inpatient (Medicare Part B only)
013x Hospital Outpatient
022x Skilled Nursing - Inpatient (Medicare Part B only)
023x Skilled Nursing - Outpatient
034x Home Health Services not under a plan of treatment
071x Clinic - Rural Health
072x Clinic - Hospital Based or Independent Renal Dialysis Center
073x Clinic - Freestanding
077x Clinic - Federally Qualified Health Center (FQHC)
085x Critical Access Hospital
N/A

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.

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 policy
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 policy should be assumed to apply equally to all Revenue Codes.

Revenue codes only apply to providers who bill these services to the fiscal intermediary or Part A MAC.
Revenue codes do not apply to physicians, other professionals and suppliers who bill these services to the
carrier or Part B MAC.

Please note that not all revenue codes apply to every type of bill code. Providers are encouraged to refer to the
FISS revenue code file for allowable bill types. Similarly, not all revenue codes apply to each CPT/HCPCS
code. Providers are encouraged to refer to the FISS HCPCS file for allowable revenue codes.


Code Description
0320 Radiology - Diagnostic - General Classification
0333 Radiology - Therapeutic and/or Chemotherapy Administration - Radiation Therapy
0340 Nuclear Medicine - General Classification
0341 Nuclear Medicine - Diagnostic
0350 CT Scan - General Classification
0352 CT Scan - Body Scan
0400 Other Imaging Services - General Classification
0402 Other Imaging Services - Ultrasound
0520 Freestanding Clinic - General Classification
0521 Freestanding Clinic - Clinic Visit by Member to RHC/FQHC
0522 Freestanding Clinic - Home Visit by RHC/FQHC Practitioner
0523 Freestanding Clinic - Family Practice Clinic
0524 Freestanding Clinic - Visit by RHC/FQHC Practitioner to a Member in a SNF or Skilled Swing Bed in a Covered Part A Stay
0525 Freestanding Clinic - Visit by RHC/FQHC Practitioner to a Member in a SNF (not in a Covered Part A Stay) or NF or ICF MR or Other Residential Facility
0527 Freestanding Clinic - Visiting Nurse Service(s) to a Member's Home when in a Home Health Shortage Area
0610 Magnetic Resonance Technology (MRT) - General Classification
0612 Magnetic Resonance Technology (MRT) - MRI - Spinal Cord/Spine
0616 Magnetic Resonance Technology (MRT) - MRA - Lower Extremities
0960 Professional Fees - General Classification
0969 Professional Fees - Other Professional Fee
0972 Professional Fees - Radiology - Diagnostic
0982 Professional Fees - Outpatient Services
0983 Professional Fees - Clinic
N/A

Other Coding Information

Group 1

Group 1 Paragraph

N/A

Group 1 Codes

N/A

N/A

Coding Table Information

Excluded CPT/HCPCS Codes - Table Format
Code Descriptor Generic Name Descriptor Brand Name Exclusion Effective Date Exclusion End Date Reason for Exclusion
N/A N/A
N/A
Non-Excluded CPT/HCPCS Ended Codes - Table Format
Code Descriptor Generic Name Descriptor Brand Name Exclusion Effective Date Exclusion End Date Reason for Exclusion
N/A

Revision History Information

Revision History Date Revision History Number Revision History Explanation
01/04/2024 R15

R15

Revision Effective: 01/04/2024

Revision Explanation: Annual review, no changes.

11/16/2023 R14

R14

Revision Effective: 11/16/2023

Revision Explanation: Updated LCD Reference Article section.

10/01/2023 R13

R13

Revision Effective: 10/01/2023
Revision Explanation: Annual ICD-10 update, added the following to Group 2:  M80.8B1A, M80.8B1D, M80.8B1G, M80.8B1K, M80.8B1P, M80.8B1S, M80.8B2A, M80.8B2D, M80.8B2G, M80.8B2K, M80.8B2P, M80.8B2S, M80.8B9A, M80.8B9D, M80.8B9G, M80.8B9K, M80.8B9P and M80.8B9S 

 

10/01/2023 R12

R12

Revision Effective: 10/01/2023
Revision Explanation: Annual ICD-10 update, added the following:  M80.8B9A, M80.8B9D, M80.8B9G, M80.8B9K, M80.8B9P, M80.8B9S, M80.0B1A, M80.0B1D, M80.0B1G, M80.0B1K, M80.0B1P, M80.0B1S, M80.0B2A, M80.0B2D, M80.0B2G, M80.0B2K, M80.0B2P, M80.0B2S, M80.0B9A, and M80.0B9D.

10/01/2023 R11

R11

Revision Effective: 10/01/2023 
Revision Explanation: Annual ICD 10 update. Added the following:  M80.0B1A, M80.0B1D, M80.0B1G, M80.0B1K, M80.0B1P, M80.0B1S, M80.0B2A, M80.0B2D, M80.0B2G, M80.0B2K, M80.0B2P, and M80.0B2S.

01/05/2023 R10

R10                                                                                                                                                                                                                                                        Revision Effective: 01/05/2023
Revision Explanation: Annual review, no changes 

10/01/2022 R9

R9

Revision Effective: 10/01/2022 
Revision Explanation: Annual ICD-10 Update, added Z79.85 to Group 1 and Group 2.

01/06/2022 R8

R8
Revision Effective: 1/6/2022
Revision Explanation: Annual review, no changes were made.

12/30/2021 R7

R7
Revision Effective:12/302021
Revision Explanation: ICD-10 codes N92.4, N95.0, N95.1, N95.2, R93.6 and R93.7 were removed from group 1 and group 2 to be in align with the NCD 150.3. These codes were included in error.

02/04/2021 R6

R6
Revision Effective: 02/04/2021
Revision Explanation: Removed limitation to avoid contradictory with information that is listed in the LCD.

12/24/2020 R5

R5
Revision Effective: 12/24/2020
Revision Explanation: Annual review, no changes were made.

01/01/2020 R4

R4
Revision Effective: 01/01/2020
Revision Explanation: Per CR 11392 codes M85.9, M89.9, and M94.9 were removed as covered indications for bone density studies effective 01/01/2020.

01/01/2020 R3

R3

Revision Effective: 01/01/2020

Revision Explanation: Added Z79.818 to group 1 and 2 ICD-10 groups as meeting medical necessity based on NCD 150.3 update.

01/01/2020 R2

R2

Revision Effective: 07/01/2019

Revision Explanation: Codes 0554T -0558T are being added to group 2 ICD-10 and group 1 under CTP codes section. These codes were effective July 1, 2019.

11/14/2019 R1

R1

Revision Effective: 11/14/2019

Revision Explanation: Bill type codes were left out in error and have been added to the article. Added regulations to the CMS National Policy section.

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Associated Documents

Medicare BPM Ch 15.50.2 SAD Determinations
Medicare BPM Ch 15.50.2
Related Local Coverage Documents
LCDs
L36460 - Bone Mass Measurement
Related National Coverage Documents
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SAD Process URL 1
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SAD Process URL 2
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Statutory Requirements URLs
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Rules and Regulations URLs
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CMS Manual Explanations URLs
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Other URLs
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Public Versions
Updated On Effective Dates Status
12/29/2023 01/04/2024 - N/A Currently in Effect You are here
11/07/2023 11/16/2023 - 01/03/2024 Superseded View
10/17/2023 10/01/2023 - 11/15/2023 Superseded View
10/17/2023 10/01/2023 - N/A Superseded View
10/17/2023 10/01/2023 - N/A Superseded View
12/28/2022 01/05/2023 - 09/30/2023 Superseded View
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