ICD-10-CM Chapters 30-33
What is the only external cause code that can be used on a subsequent visit?
"Cause" code, goes with you as long as the injury is being coded.
What are the different types of external cause codes?
C-cause A-activity P-place S-status
If a reduction is done on a closed fracture what is the approach?
External
Where are you in the PCS book if an External Fixation is done.
Immobilization or Traction
If an Internal Fixation is completed WITHOUT an open reduction, what is the root operation?
Insertion with Percutaneous Approach
what do you code first for under dosing?
Medical condition (example seizures), medication, and non compliance code if applicable
What is the rule of 9's?
9% on arms 18% on front of trunk 18% on back of trunk 18% on each leg and 1% for genitals
What are the big three 7th character's in the injury chapter?
A- Initial/Active treatment D- Subsequent/Aftercare treatment S- (the the cause of the sequela)
If a patient is still having concussion like symptoms after the 48 hours, what is the patient most likely experiencing?
Post Concussion Syndrome
What is the root operation for closing a wound?
Repair
If an ORIF (Open Reduction w/ Internal Fixation) is done what is the root operation?
Reposition
What root operation do you use for the reduction of a dislocated joint?
Reposition
What root operation is being used for reduction or manipulation of bone fractures?
Reposition
Explain how to code an ORIF.
Reposition with Open Approach-Device
What do you sequence first with a poisoning
T code for drug, then the manifestation
What do you sequence first for a toxic effect?
T code toxin then manifestation
How would you sequence infected burns?
The burn code itself, then the skin infection code
If you have multiple burns how do you sequence them?
The most severe first
If you have multiple cause codes coded, how do you sequence them?
Abuse Terrorism Cataclysmic Events Transport Other direct causes
Can you use activity codes outside of injury codes?
Yes, for illnesses
If documentation doesn't tell you that a poisoning is assault, accidental etc, what do you go with?
accidental
If you take two meds that were both prescribed by the physician and have a reaction, what is that?
adverse effect
When you are indexing and injury what does the term "and" mean?
and/or
How do you code a displaced joint?
as a disclotaion
How do you code a dislocated bone?
as a fracture
What does it mean if a patient that has undergone a CABG and now has atherosclerosis in the bypass vessels?
as a progression of the disease
If a physician documents % burned, how do you code that?
as a secondary code
How is sunburn coded?
as dermatitis
How many external cause codes can you put on an account?
as many as you need
How would you see a non-mechanical complication occur?
infections, blood clots, thrombosis, fibrosis
If documentation states a dislocation of a bone and a fracture what are you going to code?
just the fracture, its a displaced fracture
If you have a skull fracture what else do you have to code with it?
loss of consciousness
What do you sequence first for adverse effects?
manifestations, the T code
What else could you have if you are coding suspected emotional abuse?
mental health code (which would be sequenced after the confirmed abuse - type of abuse)
Do you code a minor debridement when you have an open fracture repair?
no
Do you code an immobilization (cast) when a reduction has been completed?
no
If you have an internal head injury, do you code a concussion with it?
no, because its just a symptom of that injury
Do you use aftercare codes with injuries and fractures?
no, because you are using the 7th character
If an ORIF is completed do you code the Internal Fixation seperately?
no, its the device and apart of the reduction code
Does the physician have to use the word complication?
no, just a cause and effect relationship
If a physician documents that a patient is anemic after surgery do you code that as a complication?
no, the physician has to state that the anemia is a direct result of the surgery.
Do you code staples and tissue adhesives when coding laceration repairs?
no, you don't code them just the repair
Can you code loss of consciousness from the EMT notes?
no, you have to have the attending carry the note over
What is a scenario of under dosing?
not taking enough medication
When are C.A.P.S codes used?
only on Initial/Active treatments
If you have a fracture that is specified as open and closed how do you code it ?
open
What do you have to know when indexing fractures?
pathological or traumatic
If you take an over the counter drug with a prescribed drug and have a reaction, what is that?
poisoning
What are non-mechanical complications?
reactions from the body
What do you have to know on Extent burned codes?
sum of all that is burned, and % of 3rd degree burned
What does the term "with" mean in the index?
that both conditions are present
When you have multiple injuries coded, what is sequenced first?
the most severe
If you have documentation of confirmed abuse, what else do you have to code?
the perpetrator
Who accesses how much of the body % is burned?
the physician
If you are taking a drug as prescribed and it has an accumulate effect, what is that?
toxic effect
If you inhale fumes and have a reaction, what is that?
toxic effect
If the physician doesn't state that a fracture is pathological or traumatic what is the default?
traumatic
Do you also have to identify the type of abuse when it is suspected abuse?
yes
If a patient regains consciousness prior to the arrival to the facility, do you still have to indicate the loss of consciousness?
yes
If you have a patient with multiple burns do you code multiple codes?
yes
Is it possible for a burn patient to come back on a subsequent visit and have some codes coded as active and some coded as sequlea?
yes
Concussion injuries usually last how long?
24-48 hours
How are injuries categorized in the tabular of the index?
body site first
What is an example of mechanical complications?
breakdown, displacement
How are fractures coded if they are not specified as open or closed?
closed
If you have a patient that comes in with multiple injuries, do you use the code for multiple injuries or do you code each one specifically?
code each one specifically unless you have lack of documentation
If a fracture isn't stated as displaced or non displaced how do you code it?
displaced
If you have multiple injuries of the same body site, with some being superficial and some being more severe what do you do with the superficial injuries?
don't code it
What is an example of a poisoning that is accidental?
drinking alcohol with prescribed medication, not taking medication as prescribed and trying to make up the dose
When coding complications of a device what do you have to know?
if it is mechanical or non-mechanical
What do you need to know when coding Abuse?
if it's confirmed or suspected type of abuse
