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Calcium is better known as an element that builds and maintains strong bones and consuming milk and milk products is regarded as a good way of getting dietary intake of this nutrient as per the 2010 Dietary Guidelines for Americans from the US Department of Agriculture and the Department of Health and Human Services. It is often recommended to drink milk in the adolescence period to achieve optimum bone mass which will help to reduce the risk of hip fractures later in life. However, researchers at the Brigham and Women’s Hospital found this widespread notion to be wrong in the case of men. The researchers point out that the proof for these associations has been vague. Higher consumption of milk can contribute to height growth, which is a risk factor for hip fractures.

The study was conducted on more than 96,000 men and women to examine the effect of teenage milk consumption on hip fractures. The participants reported their milk consumption as teenagers and the study involved over 22 years of follow-up. The follow-up study found men who consumed four or more glasses of milk a day as teenagers were 1.9 cm (on an average) taller as adults compared to those men who consumed two or fewer glasses a week. As per the study, the women were 1.7 cm taller. Overall, men reported greater consumption of milk in their adolescence period (2.1 glasses per day) than women (1.6 glasses per day).

The study concluded that milk consumption between the ages of 13 and 18 is associated with higher risk of hip fractures in men and each additional glass of milk in a day can increase the risk by 9% while there is no association between teenage milk consumption and increased risk of hip fractures in women. The researchers found the positive association between milk consumption and hip fractures in men is partially due to the mediating effect of height. However, they emphasized the need for further research to clearly define the role of early milk consumption and height in order to prevent hip fractures later in life.

Accurate Medical Coding – A Major Factor in Research and Patient Follow-up

Medical research such as the above is very important with regard to identifying the causes of particular conditions and planning the right treatment. Physicians must document each and every symptom, history and other relevant details of their patients. Accurate medical coding is a major factor in research and patient follow-up as well as with regard to providers receiving the correct reimbursement for their services.

If we take the case of medical coding for falls and hip fractures, the important considerations would be:

  • Accurate diagnostic coding of falls
  • Proper diagnostic coding of hip fractures in the presence of osteoporosis
  • Appropriate diagnostic codes to fully identify and elaborate conditions such as pre-existing morbid conditions like osteoporosis, pre-existing conditions that made the patient vulnerable to a pathologic fracture, which may include osteoporosis or tumor
  • Informing the payer on the insurance form that a patient sustained the pathological fracture on account of a pre-existing condition. This will help identify risk factors and suggest that the patient may require extended or comprehensive care. This will also help establish medical necessity if longer hospital stays, frequent home care, or extended care is needed. When secondary conditions are reported, the insurer will understand how the fracture was sustained. Moreover, it will also prove helpful in research coding.

Medical Coding – Diagnosis Codes for Hip Fractures

Let us look at some of the codes that can be reported for hip fractures.

Stress Fractures

ICD-9

  • 733.96: Stress fracture of femoral neck

ICD-10

  • M84.359: Stress fracture, hip, unspecified
  • M84.359A: Stress fracture, hip, unspecified, initial encounter for fracture
  • M84.359D: Stress fracture, hip, unspecified, subsequent encounter for fracture with routine healing
  • M84.359G: Stress fracture, hip, unspecified, subsequent encounter for fracture with delayed healing
  • M84.359K: Stress fracture, hip, unspecified, subsequent encounter for fracture with nonunion
  • M84.359P: Stress fracture, hip, unspecified, subsequent encounter for fracture with malunion
  • M84.359S: Stress fracture, hip, unspecified, sequela

Pathological Fractures

ICD-9

  • 733.14: Pathologic fracture of neck of femur

ICD-10

  • M84.459: Pathological fracture, hip, unspecified
  • M84.459A: Pathological fracture, hip, unspecified, initial encounter for fracture
  • M84.459D: Pathological fracture, hip, unspecified, subsequent encounter for fracture with routine healing
  • M84.459G: Pathological fracture, hip, unspecified, subsequent encounter for fracture with delayed healing
  • M84.459K: Pathological fracture, hip, unspecified, subsequent encounter for fracture with nonunion
  • M84.459P: Pathological fracture, hip, unspecified, subsequent encounter for fracture with malunion
  • M84.459S: Pathological fracture, hip, unspecified, sequela
  • M84.559: Pathological fracture in neoplastic disease, hip, unspecified
  • M84.559A: Pathological fracture in neoplastic disease, hip, unspecified initial encounter for fracture
  • M84.559D: Pathological fracture in neoplastic disease, hip, unspecified subsequent encounter for fracture with routine healing
  • M84.559G: Pathological fracture in neoplastic disease, hip, unspecified subsequent encounter for fracture with delayed healing
  • M84.559K: Pathological fracture in neoplastic disease, hip, unspecified subsequent encounter for fracture with nonunion
  • M84.559P: Pathological fracture in neoplastic disease, hip, unspecified subsequent encounter for fracture with malunion
  • M84.559S: Pathological fracture in neoplastic disease, hip, unspecified sequela
  • M84.659: Pathological fracture in other disease, hip, unspecified
  • M84.659A: Pathological fracture in other disease, hip, unspecified initial encounter for fracture
  • M84.659D: Pathological fracture in other disease, hip, unspecified subsequent encounter for fracture with routine healing
  • M84.659G: Pathological fracture in other disease, hip, unspecified subsequent encounter for fracture with delayed healing
  • M84.659K: Pathological fracture in other disease, hip, unspecified subsequent encounter for fracture with nonunion
  • M84.659P: Pathological fracture in other disease, hip, unspecified subsequent encounter for fracture with malunion
  • M84.659S: Pathological fracture in other disease, hip, unspecified sequela

The increased number of codes and specificity with ICD-10 demand more accurate documentation from physicians. A professional medical billing and coding company can help physicians and researchers save their time spent on copious documentation. A reliable firm can also ensure excellent revenue management so that physicians remain stress-free, and can focus more on research and on providing healthcare service.