ED Coding and Reimbursement Alert

Test your coding knowledge.  Determine how you would code this situation before looking at the box below for the answer.
Question: On occasion, we see patients in our emergency department for unusual reasons. For instance, we may need to verify an individual's gender so a mistake on his driver's license can be corrected or because he was exposed to blood at an accident scene without being injured. Shall we assign some type of symptom diagnosis code, or should we use the ICD-9 V codes?

Answer: When a patient is asymptomatic, an ED coder must usually rely on the V codes. For instance, the diagnosis code on a claim for a patient examined after being exposed to blood would be V15.85 (other specified personal history presenting hazards to health; exposure to potentially hazardous body fluids).
 
If the patient also exhibits symptoms, however, those would be reported in the primary position on the claim form. Perhaps a passenger in a car involved in an accident sustained a laceration to the hand and was exposed to another individual's blood. An ED visit would be reported, along with a diagnosis code describing the hand wound (e.g., 882.0, open wound of hand except finger[s] alone; without mention of complication) in the primary position and V15.85 in the secondary position. An E code to explain the circumstances of the accident would also be assigned.