What ICD-10 (International Classification of Diseases, 10th Revision) diagnoses meet medical necessity for a Computed Tomography (CT) scan of the pelvis related to the sacrum?

From the Guidelines

Medical necessity for a CT scan of the pelvis related to the sacrum can be established with several ICD-10 diagnoses, including S32.1, M53.3, M46.1, C41.4, M48.08, and M43.28, as supported by the most recent study 1. These diagnoses justify a CT scan when clinical evaluation suggests structural abnormalities of the sacrum requiring detailed imaging.

• The most appropriate diagnoses include:
  • S32.1 (fracture of sacrum)
  • M53.3 (sacrococcygeal disorders)
  • M46.1 (sacroiliitis)
  • C41.4 (malignant neoplasm of pelvic bones, sacrum, and coccyx)
  • M48.08 (spinal stenosis of sacral and sacrococcygeal region)
  • M43.28 (sacroiliac subluxation)
• Additional relevant codes include:
  • M43.08 (spondylolysis of sacral region)
  • S33.2 (dislocation of sacroiliac joint)
  • M46.28 (osteomyelitis of sacrum)
  • R29.3 (abnormal posture) when related to sacral issues CT scans are particularly valuable for evaluating the sacrum because they provide excellent bony detail that may not be visible on plain radiographs, allowing for precise assessment of fractures, tumors, inflammatory conditions, and degenerative changes, as noted in 1 and 1. The three-dimensional reconstruction capabilities of CT imaging are especially helpful for surgical planning when intervention is being considered for sacral pathology, as highlighted in 1.

From the Research

ICD 10 Diagnoses for CT Scan Pelvis Related to Sacrum

The following ICD 10 diagnoses may meet medical necessity for a CT scan pelvis related to sacrum:

• Sacral fracture (S32.1-), which is a common component of pelvic fracture patterns 2, 3
• Pelvic ring injury (S32.4-), which can be associated with sacral fractures 4, 5
• Osteoporosis (M80.-), which can increase the risk of sacral fractures 3
• Traumatic insults, such as high-energy trauma, which can cause sacral fractures 2, 5

Classification Systems and Management

There are various classification systems for sacral fractures, including historic and newer systems 2, 3. The management of sacral fractures depends on the type and severity of the fracture, as well as the presence of associated injuries 2, 3, 5.

Importance of CT Imaging

CT imaging is essential for diagnosing sacral fractures, especially in the elderly population, as plain radiographs can miss up to 57% of lip fractures and 34% of vertical shear fractures 4, 6. CT scans can provide a more accurate diagnosis and better delineate the extent of injury 6.

Associated Injuries

Sacral fractures are often associated with other injuries, including:

• Neurologic injuries (up to 50% of sacral fractures) 5
• Pelvic ring disruptions 5
• Hip and lumbar spine fractures 5
• Active pelvic/abdominal bleeding 5
• Open fracture or significant soft tissue injury 5