ED Coding and Reimbursement Alert

Question: The physician removed a "hair tourniquet" of human hair wound tightly around a patient's third and fourth toes. There was no injury, but the toes were very red and swollen. What diagnosis should we code?

Connecticut Subscriber

Answer: Your best choice is 917.8 (Other and unspecified superficial injury of foot and toes without mention of infection). If the tourniquet led to infection, change to 917.9 (Other an unspecified superficial injury of foot and toes, infected).

The ICD-9 index lists hair tourniquet under "syndrome," which then leads you to "superficial injury by site" and 917.8 or 917.9.

Consider this: You could also include E928.4 (External constriction caused by hair) on the claim. You aren't always required to report E codes, but they do provide more specific information about an injury.