CPT® Code 77086

Vertebral fractures are a significant health concern, particularly among the elderly population, where they often remain undiagnosed and unrecognized. The procedure for assessing these fractures is known as vertebral fracture assessment, which utilizes dual-energy X-ray absorptiometry (DXA). This advanced imaging technique employs two X-ray beams of differing energy levels directed at the bones in alternating pulses. The process is enhanced by the use of densitometers and specialized software that interprets the data collected during the scan. During the assessment, the patient is typically positioned either supine or in a left decubitus position, allowing for a comprehensive lateral scan of the spine using a rotating arm. One of the key advantages of DXA is its low radiation exposure, which is sufficient to detect vertebral fractures while not revealing other bone or soft tissue abnormalities. The assessment categorizes vertebral fractures into three grades based on the degree of height reduction: Grade I fractures exhibit a 20-24% decrease in vertebral height, Grade II fractures show a 25-39% decrease, and Grade III fractures are characterized by a 40% or greater decrease. Additionally, the assessment may identify the specific location of the vertebral deformity, which can manifest as an endplate deformity (located at the midheight of the vertebra), a wedge deformity (affecting the anterior and midheight), or a crush deformity (involving the entire vertebra). This detailed evaluation is crucial for diagnosing and managing vertebral fractures effectively.