Brush Up on How to Code Minor Household Injuries
Do you know how to navigate all 7 layers of the S00.- to T88.- code set? Minor household injuries typically do not conjure up mental images of complex care; in fact, they are one of the simplest reasons why someone may seek medical attention. Though “just a little burn” from a cookie sheet or “just a scratch” from a broken glass may seem like uncomplicated cases, coding these injuries requires a thorough understanding of the Injuries, Poisonings, and Certain Other Consequences of External Causes (S00.- to T88.-) range of the 10th edition of the ICD-10-CM code set. Coders must pay close attention to the patient’s medical record to determine the exact location and type of injury in order to select the most appropriate code from the extensive S00.- to T88.- code set. Each code in this range contains seven characters, and mastering this range takes intricate knowledge of the code set’s structure. Refresh your knowledge of this code set with these tips for coding minor household injuries. Know How to Navigate S00.- to T88.- The S00.- to S99.- range is primarily organized by the location of the injury; the T07.- to T88.- range includes poisoning, frostbite, and other complications of trauma: For example, say a child fractured their forearm and scraped their knee by falling off their bicycle. It’s best practice to code the most severe injury first, so start with the forearm fracture. Refer to S50.- to S59.- (Injuries to the elbow and forearm) and select S52.- (Fracture of forearm). From there, refer to the child’s medical record to determine whether the fracture is in the radius or ulna, and if it involves the upper or lower end of the bone. For the purposes of this example, let’s say it’s the upper end of the ulna, so the most appropriate code is S52.0- (Fracture of upper end of ulna). Next, specify the fracture type if known. In this example, the child has a torus fracture, so the coder should use S52.01- (Torus fracture of upper end of ulna). Then, choose the code that corresponds with the correct arm. In this case, the fracture is in the left arm, so S52.012- (Torus fracture of upper end of left ulna) is the correct code set. Finally, choose the code that best applies to the patient’s healing status. For this example, let’s say we are coding the initial encounter. Therefore, the final correct code is S52.012A (Torus fracture of upper end of left ulna, initial encounter for closed fracture). After sifting through numerous code sets to drill down to that final 7-character code, it’s easy to forget about the scraped knee. But this example is incomplete without adding on that code if the patient’s care also involved their scraped knee. Zoom out and begin with S80.- to S89.- (Injuries to the knee and lower leg), then select S80.- (Superficial injury of the knee and lower leg). Refer to S80.2- (Other superficial injuries of knee) to find S80.21- (Abrasion of knee). In this example, the patient fell on their left side, so the proper code set is S80.212- (Abrasion, left knee). Finally, we know that this is the initial encounter, so the correct code is S80.212A (Abrasion, left knee, initial encounter). Keep ‘Excludes’ Notes in Mind for Minor Household Injuries Keep in mind that Excludes1 and Excludes2 notes may apply to codes in the S00.- to T88.- range. In the bicycle accident example, there are several Excludes2 notes and one Excludes1 note that apply to the forearm fracture and scraped knee. Let’s review the notes for the forearm fracture. The S52.- range has the following notes: The S52.0 range has two additional Excludes2 notes: S42.40- (Fracture of elbow NOS) and S52.2- (Fractures of shaft of ulna). If applicable, use the code listed in the Excludes2 note for any of the codes in the S00.- to T88.- range, and remember that Excludes1 notes indicate that two codes are mutually exclusive, so coders should not use them together. Michelle Falci, BA, M Falci Communications LLC
