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Coding Injuries In ICD -10-CM

Author: Poojitha Avanaganti
by Poojitha Avanaganti
Posted: Nov 21, 2017
seventh character

ICD-10-CM offers greater specificity in coding lesions than ICD-9-CM. Although many guidelines for the coding of injuries remain the same as those in ICD-9-CM, the ICD-10-CM includes some new features, such as the seventh character extensions.

In ICD-10-CM, injuries are grouped by body part rather than by category, so that all injuries at a specific site (such as head and neck) are grouped together rather than groupings of all fractures. or all open wounds. Categories grouped by ICD-9-CM lesions such as fractures (800-829), dislocations (830-839) and sprains and strains (840-848) are grouped by site according to ICD-10- CM, such as head injuries (S00-S09), neck injuries (S10-S19) and chest injuries (S20-S29).Know more at Medical Coding Training Hyderabad

Injury extensions:

Most of the categories in Chapter 19 have seventh character extensions that are required for each applicable code, and most categories have three extensions (with the exception of fractures):

  • An initial meeting
  • D, later meeting
  • S, Sequela

Extensions for initial encounters are used while the patient is receiving active treatment for the injury (for example, surgical treatment, meeting with an emergency department, and evaluation and treatment by a new physician). The extensions for the following meetings are used for meetings after the patient has received active treatment of the injury and receives routine care for the injury during the healing or recovery phase (eg, casting change or withdrawal, removal of external fixation device, adjustment, other follow-up care and follow-up visits following treatment of injuries).

Extension S, sequelae, is used for complications or conditions that arise directly from an injury, such as scarring after a burn. Scars are a sequel to the burn. When using the S extension, it is necessary to use both the wound code that precipitated the sequel and the sequel code itself. S is added only to the injury code, not to the sequential code.

The extension S identifies the injury responsible for the sequelae. The specific type of sequel (eg scar) is sequenced first, followed by the lesion code. Sequela is the new terminology of ICD-10-CM for the late effects of ICD-9-CM and the use of sequential extension replaces the ICD-9- late effects categories (905-909).

Fracture coding:

The ICD-10-CM fracture codes offer greater specificity than ICD-9-CM. For example, ICD-10-CM fracture codes can indicate the type of fracture (eg, green, transverse, oblique, spiral, fragmented), the specific anatomical site, whether the fracture is displaced or not, laterality, pseudarthrosis, and slander. Laterality and type of encounter (initial, subsequent, sequelae) are significant components of code expansion.

To provide additional specificity, fracture extensions are expanded to include:

  • A, initial encounter for closed fracture
  • B, initial encounter for open fracture
  • D, Subsequent Encounter for Fracture with Routine Healing
  • G, Subsequent Encounter for Fracture with Delayed Healing
  • K, Subsequent meeting for fracture with pseudarthrosis
  • P, Subsequent Encounter for Fracture with Cal malice
  • S, Sequela

Some categories of fractures provide seventh-character extensions for the specific type of open fracture. These designations are based on the Gustilo open fracture classification and apply to categories S52 (Forearm Fracture), S72 (Femur Fracture) and S82 (Lower Leg Fracture).

The Gustilo open fracture classification for extremities classifies open fractures into three main categories (types) based on lesion mechanism, soft tissue injury, and degree of skeletal involvement. The classes are I, II and III, with the third class subdivided into A, B or C.

The Gustilo classification is used to identify the severity of soft tissue injury. The rates of healing, infection, and amputation of fractures correlate with the degree of soft tissue injury by Gustilo and help determine the prognosis.For more details Medical Coding Training Hyderabad

The available extensions for these open fractures are:

  • B, initial encounter for open fracture type I or II
  • C, initial encounter for type of open fracture IIIA, IIIB or IIIC
  • E, a subsequent encounter with open fracture type I or II with routine healing.
About the Author

This is poojitha working as a medical coder at Andromedatechs

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Author: Poojitha Avanaganti

Poojitha Avanaganti

Member since: Nov 15, 2017
Published articles: 7

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