A: Only when there is evidence of a codeable cord injury associated with the spondylolisthesis would you code this injury which is actually a slippage of one vertebrae on another. For the spine this is coded as a dislocation with the cord compression of first consideration leading the code selection Code 640606.3

Thank you to those who offered comments. This is one of the cases that looks like we are splitting hairs when trying to code as specifically as there is evidence for; and with either code 640200.3 NFS or the more specific code 640206.3 you have the same severity. The documentation definitely refers to the spondylolisthesis (slippage/displacement of one vertebrae on another) as the traumatic cause of the severe cord compression, not a spinal bleed or such and not age related slippage of a vertebrae. This is a traumatic horizontal displacement of vertebrae impinging on the cord so the cord compression with dislocation(sideways) most specifically describes this injury. The severe pain(more than numbness or tingling and not transient) and cord compression is the evidence of the severity of the spondylolisthesis as an acute traumatic injury. A rare instance.

Coding NOTE: Coders should be aware that most often spondylolisthesis is a common finding due to degenerative processes and should not be routinely considered to be a traumatic injury.