ICD Code M48.55XS

ICD code M4855XS is used to classify a condition where there is a collapsed vertebra in the thoracolumbar region of the spine, which is not specified elsewhere in the classification system. This code specifically indicates that the collapse is a sequela, meaning it is a condition that is a direct consequence of a previous fracture. In this context, "sequela" refers to the long-term or residual effects that remain after the initial injury has healed. This code is crucial for healthcare providers to accurately document and manage the ongoing care and treatment of patients who have experienced such spinal injuries.

When to use the ICD code M4855XS:

1. Diagnosis of Collapsed Vertebra: The patient must have a confirmed diagnosis of a collapsed vertebra in the thoracolumbar region.

2. History of Fracture: There should be a documented history of a fracture that has led to the collapse of the vertebra.

3. Sequela Present: The patient must exhibit symptoms or conditions that are a direct result of the previous fracture, indicating a sequela.

4. Location Specification: The collapsed vertebra must specifically be located in the thoracolumbar region, which includes the lower thoracic and upper lumbar vertebrae.

5. Exclusion of Other Classifications: The condition must not be classified elsewhere in the ICD coding system, confirming that it is unique to this diagnosis.

6. Clinical Symptoms: The patient may present with symptoms such as:

- Back pain localized to the thoracolumbar region

- Neurological deficits (e.g., weakness, numbness) if spinal cord involvement is present

- Limited mobility or functional impairment due to vertebral collapse

7. Radiological Evidence: Imaging studies (e.g., X-rays, MRI) should confirm the presence of a collapsed vertebra and any associated changes due to the fracture.

8. Time Frame: The coding should reflect that the sequela is occurring after the initial fracture has healed or stabilized, indicating a chronic condition resulting from the acute injury.

For the ICD code M48.55XS, which pertains to a collapsed vertebra in the thoracolumbar region as a sequela of a fracture, the relevant CPT codes that may be applicable for treatment include:

1. 22510 - Percutaneous vertebroplasty (bone cement injection) for the thoracic vertebral body.

2. 22511 - Percutaneous vertebroplasty (bone cement injection) for the lumbar vertebral body.

3. 22512 - Each additional thoracic or lumbar vertebral body (List separately in addition to code for primary procedure).

4. 22513 - Percutaneous vertebral augmentation, including cavity creation (e.g., kyphoplasty) for the thoracic vertebral body.

5. 22514 - Percutaneous vertebral augmentation, including cavity creation (e.g., kyphoplasty) for the lumbar vertebral body.

6. 22515 - Each additional thoracic or lumbar vertebral body (List separately in addition to code for primary procedure).

7. 22899 - Unlisted procedure, spine (used when a specific procedure does not have a designated CPT code).

These CPT codes are typically used for procedures aimed at stabilizing or treating vertebral fractures and related conditions in the thoracolumbar region. It is important for healthcare providers to verify the most current coding guidelines and payer-specific requirements when selecting the appropriate CPT codes for billing purposes.

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