Read also: How to perfectly code a Medical Record Once you solve such medical reports of non-traumatic fractures, you wiill become perfect in the diagnosis coding of fractures. I have come across many coding scenarios like to find an ICD 10 code for pathological fracture of vertebrae, femur, humerus or in neoplastic disease. Minor injuries cannot cause fractures in the healthy bones. But, if the patient comes with a fracture with minor injury and weak bones, the record should be coded with pathological fractures. Generally, traumatic fractures occur because of any Motor vehicle accident, of a fall from high level, hit by a heavy object etc. Hence, while coding a traumatic fracture, one should thoroughly check the medical record for any significant trauma. However, due to the weaking of bones the pathological fractures occur with even a slight trauma or injury. Fractures generally occur when there is major or significant trauma. These fractures are spontaneous and occur in connection with minor injuries. How to confirm it is a Pathological fracture?Īs I have said, diseases like osteoporosis can cause Pathological fracture. Read also: Learn how to code ICD 10 codes for Osteoarthritis Now, here the question arises whether we should code a traumatic fracture or a Non-traumatic (pathological) fracture in such scenarios. The bone diseases are harmful for older patients because bones are damaged or injured with slight trauma or injury. Such fractures are called Pathological fracture. Sometimes even doing your day to day activity can lead to fracture, which is absolutely non-traumatic. Due to less bone density in old age, the bones get fractures even with a small injury. Due to decrease in density, we may suffer from osteopenia or osteoporosis. As we grow older, our bone density starts decreasing. Scoring systems have been developed to assess the fracture risk of bone metastases, the Mirels classification is the one that has gained the most traction, although its poor sensitivity (35%) means that it is not without its controversy 5.Fractures can be coded as traumatic or non-traumatic fractures. In principle, every osteolytic focus in the femoral neck or the spine is at risk of a pathological fracture. Practical pointsĪ radiologist should mention the possibility of a pathological fracture if an osteolytic metastasis is seen. Pathological fractures are feared by oncologists because they may cause immobilization of their patients, especially when the spine or lower extremities are affected. In addition, in adult patients, the avulsion of the femoral lesser trochanter should be considered a pathological fracture until proven otherwise 4. The most common location for pathological fractures are 4: Fragility fractures on the other hand, are acute fractures in osteoporotic patients due to a single event of minimal trauma. Insufficiency fractures are fractures due to multiple minor events causing a cumulative load on weakened osteoporotic bone. Paget disease, osteopetrosis), although the term insufficiency fracture is probably more correct 4. It can be used in the setting of generalized metabolic bone disease (e.g. The term pathological fracture is usually reserved for tumors, either benign or malignant, although it has been used in the setting of osteomyelitis.