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June 25, 2021

I have a patient that has an “Osteoporotic L4 burst fx” after opening a window and twisting something in her back. I just want to make sure I am thinking correctly that this would be included as a PTOS?

No, not necessarily. If they are saying this is osteoporotic, and therefore pathological, then no it wouldn’t be PTOS. That could get coded to M80.08XA, Age-related osteoporosis with current pathological fracture, vertebra OR M80.88XA, Other osteoporosis with current pathological fracture, vertebra. Neither of those two codes are in our inclusion.

In order to qualify for PTOS, it has to be determined as a traumatic fracture, not pathological. Then it would be assigned a traumatic fracture code in the inclusion criteria. You may need to query your surgeon for determination.

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