General Surgery Coding Alert

Expect more detail for wound type, location.

If you thought ICD-9 provided a lot of granularity for reporting open wounds, think again. You won’t believe the detail you’ll need to document when ICD-10 goes into effect on Oct. 1, 2014.

Describe Cut’s Nature

Although the ICD-9 codes primarily use the terms “open wound” or “laceration,” you’ll need to have more information to describe the wound under ICD-10. For instance, the ICD-10 codes often distinguish laceration, puncture wound, and open bite using different codes.

On the other hand, ICD-9 provides some distinctions that you won’t find in ICD-10, such as specifying “full thickness wound” or “with complications.”

Isolate Location

Although both ICD-9 and ICD-10 identify the wound’s anatomic site, such as eyelid or neck, ICD-10 provides more specificity by including “right,” “left,” or “unspecified” for bilateral sites.

Example: Let’s see how ICD-9 and ICD-10 stack up for open wounds of the eyelid and surrounding tissue (excluding the orbit or eyeball).

ICD-9 code choices:

• 870.0 — Laceration of skin of eyelid and periocular area
• 870.1 — Laceration of eyelid full-thickness not involving lacrimal passages
• 870.2 — Laceration of eyelid involving lacrimal passages
• 870.8 — Other specified open wounds of ocular adnexa
• 870.9 — Unspecified open wound of ocular adnexa.

ICD-10 code choices:

• S01.10-- — Unspecified open wound of eyelid and periocular area
• S01.11-- — Laceration without foreign body of eyelid and periocular area
• S01.12-- — Laceration with foreign body of eyelid and periocular area
• S01.13-- —Puncture wound without foreign body of eyelid and periocular area
• S01.14-- — Puncture wound with foreign body of eyelid and periocular area
• S01.15-- — Open bite of eyelid and periocular area.

Notice that each of these codes requires a sixth and seventh digit, as follows:

Sixth digit:

1 = right

2 = left

9 = unspecified.

Seventh digit:

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

Bottom line: ICD-10 provides 54 seven-digit codes to replace ICD-9’s five four-digit codes describing wounds to the eyelid and periocular area.