ED Coding and Reimbursement Alert

Question: An elderly patient reports to the ED for inspection of sores on her back. The nonphysician practitioner (NPP) diagnoses a stage I pressure ulcer on her lower back. How should I report this diagnosis? Indiana Subscriber Answer: You should submit a pair of codes: one to represent the stage of the pressure ulcer and another for the ulcer itself. On the claim, report 707.03 (Pressure ulcer; lower back) to represent the pressure ulcer and 707.21 (Pressure ulcer stage I) to represent the pressure ulcer's stage. Explanation: Use the "stage" codes (707.2x) to describe the status of the patient's wound -- but code the ulcer location first using 707.00-707.09. -- Reader Questions and You Be the Coder reviewed by Michael A. Granovsky, MD, CPC, FACEP, president of MRSI, an ED coding and billing company in Woburn, Mass.