Go Back   AAPC Medical Coding & Billing Forums > Medical Coding > Diagnosis Coding
Forum Rules FAQ Members List Calendar Search Today's Posts Mark Forums Read

View Poll Results: What ICD-9 would you use for bite, cat, finger - no open wound mentioned in Hx or PE
883.0 7 43.75%
923.3 3 18.75%
959.5 7 43.75%
Multiple Choice Poll. Voters: 16. You may not vote on this poll

Reply
 
Thread Tools
  #1  
Old 11-17-2009, 09:37 AM
chief1kee chief1kee is offline
New
 
Join Date: Apr 2007
Location: Daytona Beach
Posts: 5
chief1kee is on a distinguished road
Red face Need Correct Coding for a dx of a cat bite, finger

I am convinced, that a animal bite is an open wound, without having to be stated as open and would code a cat bite of finger with 883.0.

However, after discussion with another coder, she always uses contusion, unless the physician documents that it was an open wound and would code a cat bite of finger 923.3.

I have been unable to convince her to where she is comfortable with the open wound ICD-9 even after looking up the definition. Following is my reasoning as to why it should be considered an open wound.
1. The definition of a bite from Tabers medical dictionary states; " 1. To cut with teeth. 2. An injury in which the body surface is torn by an insect or animal, resulting in abrasions, punctures, or lacerated wounds. 3b. Specific for cat. A wound inflicted by the teeth of a cat; typically a puncture wound on the hand or the arm."

2. Since the medical definition states an open wound, it would then put the resposibility of the physician to state the the skin was intact to change the normal definition. Not the other way around.


The ICD-9 book only states Bite(s), animal - see Wound, open, by site
intact skin surface - See Contusion.

Please give me feedback good enough to be able to convince the other coder or correct me if I am wrong.

Last edited by chief1kee; 11-18-2009 at 07:09 AM. Reason: Added My reasoning for this to be an open wound
Reply With Quote
  #2  
Old 11-17-2009, 11:58 AM
AuntJoyce AuntJoyce is offline
Guru
 
Join Date: Apr 2007
Posts: 170
AuntJoyce is on a distinguished road
Thumbs up Cat bite - open vs closed

I have always erred on the side of caution and never code it as an open wound unless the dictation clearly states that the skin was broken. I am a firm believer in, "when in doubt, leave it out"..."if they don't say it, we can't know it". I always imagine sitting in the witness box, being sworn in and being asked, "where does it say that the bite broke the skin?" I like life on the outside and don't plan going on the inside if I can help it.

Joyce
Reply With Quote
  #3  
Old 11-17-2009, 01:16 PM
FTessaBartels FTessaBartels is offline
True Blue
 
Join Date: Apr 2007
Location: Milwaukee WI
Posts: 4,436
FTessaBartels will become famous soon enough
Default ICD9 pretty clear

I agree with Joyce. ICD9 is pretty clear on this ... if there is no mention of an open wound then you have intact skin so you code from the contusion area.

F Tessa Bartels, CPC, CEMC
Reply With Quote
  #4  
Old 11-17-2009, 01:22 PM
mitchellde's Avatar
mitchellde mitchellde is offline
True Blue
 
Join Date: Apr 2007
Location: Columbia, MO
Posts: 8,288
mitchellde will become famous soon enoughmitchellde will become famous soon enough
Default

I agree too I have had children bitten befor and there was no break in the skin just a brusing with indentations so I would not begin to assume it was an open wound. Now if he documents that sutures were applied then you might have an argument.
__________________

Debra A. Mitchell, MSPH, CPC-H
Reply With Quote
  #5  
Old 11-17-2009, 01:35 PM
RebeccaWoodward* RebeccaWoodward* is offline
True Blue
 
Join Date: Apr 2007
Location: North Carolina
Posts: 3,129
RebeccaWoodward* will become famous soon enough
Thumbs up

Quote:
Originally Posted by AuntJoyce View Post
I have always erred on the side of caution and never code it as an open wound unless the dictation clearly states that the skin was broken. I am a firm believer in, "when in doubt, leave it out"..."if they don't say it, we can't know it". I always imagine sitting in the witness box, being sworn in and being asked, "where does it say that the bite broke the skin?" I like life on the outside and don't plan going on the inside if I can help it.

Joyce
Nicely said...
Reply With Quote
  #6  
Old 11-17-2009, 01:46 PM
Lisa Bledsoe Lisa Bledsoe is offline
True Blue
 
Join Date: Apr 2007
Location: Greeley, Colorado
Posts: 2,043
Lisa Bledsoe is on a distinguished road
Default

Without documentation stating an open wound, I like 959.5 becuase it states "injury other and unspecified". A contusion is a bruise which is also not stated with the information provided in the question.
__________________
Lisa Bledsoe, CPC, CPMA
Reply With Quote
  #7  
Old 11-17-2009, 03:11 PM
Cyndi113's Avatar
Cyndi113 Cyndi113 is offline
True Blue
 
Join Date: Apr 2007
Location: Phoenix, AZ
Posts: 613
Cyndi113 is on a distinguished road
Default

I agree with Lisa. I vote for the 959.5 plus and E code to reflect the cat bite. I think if a cat bit hard enough to leave a bruise, more than likely it would break the skin??
__________________
Cyndi Allen, CIRCC, CPC
Reply With Quote
  #8  
Old 11-18-2009, 01:15 PM
eadun2000 eadun2000 is offline
Expert
 
Join Date: Apr 2007
Posts: 484
eadun2000 is on a distinguished road
Default

959.5 plus obviously E codes. You cannot code for open wound if there is not one documented and you cannot code for a contusion if there is not one documented... the only choice you have left is 959.5
Reply With Quote
  #9  
Old 11-18-2009, 08:42 PM
+91 9094532789's Avatar
+91 9094532789 +91 9094532789 is offline
Networker
 
Join Date: Apr 2007
Location: International Member
Posts: 26
+91 9094532789 is on a distinguished road
Default 883.0

I will go with 883.0
__________________
Thanks
Thyagarajan Munuswamy CPC CCS

"Man needs his difficulties because they are necessary to enjoy success".
ABDUL KHALAM - Former President of INDIA
Reply With Quote
  #10  
Old 11-19-2009, 08:34 AM
eadun2000 eadun2000 is offline
Expert
 
Join Date: Apr 2007
Posts: 484
eadun2000 is on a distinguished road
Default

Quote:
Originally Posted by +91 9035691119 View Post
I will go with 883.0
How do you come up with 883.0?
Reply With Quote
Reply

Thread Tools

Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is On
HTML code is Off




Disclaimer: Although AAPC staff members will monitor these forums periodically, we cannot be responsible for the information posted herein, nor guarantee its accuracy. Our members may discuss various subjects related to medical coding, but none of the information should replace the independent judgment of a physician for any given health issue. Please note that the opinions expressed here do not necessarily reflect those of AAPC.

All times are GMT -6. The time now is 03:52 PM.

AAPC - Top

Powered by vBulletin® Version 3.8.1
Copyright ©2000 - 2014, Jelsoft Enterprises Ltd.
Copyright ©2014, AAPC