ED Coding and Reimbursement Alert

Question: Our ED recently treated a patient for a gunshot wound from a pistol to the jaw; the ED physician had to remove the bullet from the patient's facial tissue. How should we report this service, especially the diagnosis? Montana Subscriber Answer: If the only procedure the physician performed was the bullet removal, you should choose 41805 (Removal of embedded foreign body from dentoalveolar structures; soft tissue) or 41806 (... bone), depending on the injury's specifics . Report ICD-9 code 873.54 (Other open wound of head; face, complicated; jaw) as the primary diagnosis. In addition, you should list E985.0 (Injury by firearms, air guns, and explosives undetermined whether accidentally or purposely inflicted; handgun) as a secondary diagnosis code to give the carrier a better picture of what happened.