ED Coding and Reimbursement Alert

Question: The physician treated a patient for "crush injury, lower forearm." What ICD-10 code would represent this injury?

Codify Subscriber

Answer: The exact ICD-10 code you choose will depend on the laterality of the crush injury, and whether the encounter for the injury is initial, subsequent, or sequela.

First:  You need to choose the appropriate base crush injury ICD-10 for the encounter. Try to find out which forearm the orthopedist treated; then, choose one of the following codes to start:

• S57.80-- - Crushing injury of unspecified forearm
• S57.81-- - Crushing injury of right forearm
• S57.82-- - Crushing injury of left forearm.

Then: Choose the correct seventh character to describe the type of visit. Your choices are:

• A - initial encounter
• D - subsequent encounter
• S - sequela.

Keep in mind: Most EDs see patients for the initial encounter only, since they only present to the emergency department upon the initial injury. Therefore, your seventh character will typically be "A." Of course, there are outliers to this rule if patients return to the ED with complications or other issues, but most of the claims will be reported with the "initial encounter" code.

So, let's say that you comb through the notes and discover the patient's right forearm is injured, and this E/M is the initial encounter for treating this injury. On the claim, you'd append S57.81XA to the appropriate ED E/M code.

Remember, the A, D, and S characters are for the seventh slotonly, so the sixth-character X is a placeholder for this ICD-10 code.