Serum C-terminal telopeptide test (CTx test) is a marker that measures bone metabolism and is supposed to determine the risk of osteonecrosis of the jaw - maxilla and mandible (ICD-9-CM diagnosis code for aseptic necrosis of the jaw is 733.45).
Practicability of the diagnostic code is bound to purpose. Some confusion in looking for the "proper” code occurs due to several misleading factors: Some practitioners prefer searching for a code associated with the condition (specifically ONJ), others look for a code associated with the procedure they are about to perform on their patients, which is jaw surgery. This is not wrong either, as the CTx test is part of treatment planning, so they pick a code associated with jaw surgery.
Some doctors and specialized physicians will use other codes, such as for inflammatory conditions of the jaw - precisely abscess, osteitis, osteomyelitis, periostitis or sequestrum of jaw bone (526.4).
This condition is an ischemic osteonecrosis (or avascular, AVN), meaning that bone cells collapse due to poor or no blood flow and need to be surgically removed. Even before the first stages of the disease, this test can estimate the jeopardy of compromised jaw bone.
This test is sometimes run prior to performing dental implants in patients who have been previously treated with diphosphonates, either for prevention or treatment of osteoporosis, or for cancer treatment.
Please note that necrosis of the jaw, such as osteoradionecrosis of jaw (ORN) - death of bone tissue following high doses of radiation - are different conditions and, thus, receive different diagnosis codes (like in 526.8 other specified diseases of the jaws > 526.89 other). CTx test refers to ONJ caused by diphosphonates.
Practicability of the diagnostic code is bound to purpose. Some confusion in looking for the "proper” code occurs due to several misleading factors: Some practitioners prefer searching for a code associated with the condition (specifically ONJ), others look for a code associated with the procedure they are about to perform on their patients, which is jaw surgery. This is not wrong either, as the CTx test is part of treatment planning, so they pick a code associated with jaw surgery.
Some doctors and specialized physicians will use other codes, such as for inflammatory conditions of the jaw - precisely abscess, osteitis, osteomyelitis, periostitis or sequestrum of jaw bone (526.4).
This condition is an ischemic osteonecrosis (or avascular, AVN), meaning that bone cells collapse due to poor or no blood flow and need to be surgically removed. Even before the first stages of the disease, this test can estimate the jeopardy of compromised jaw bone.
This test is sometimes run prior to performing dental implants in patients who have been previously treated with diphosphonates, either for prevention or treatment of osteoporosis, or for cancer treatment.
Please note that necrosis of the jaw, such as osteoradionecrosis of jaw (ORN) - death of bone tissue following high doses of radiation - are different conditions and, thus, receive different diagnosis codes (like in 526.8 other specified diseases of the jaws > 526.89 other). CTx test refers to ONJ caused by diphosphonates.
