Pathology/Lab Coding Alert

Question: The lab received an order for an HIV test as part of a workers' compensation claim based on the following explanation: A nurse accidentally stuck herself with the needle after drawing blood from a patient with serologic evidence of HIV. OSHA guidelines require that the nurse receive an HIV test. What is the proper <ICD9 coding for this scenario?


Illinois Subscriber


Answer: To report the accidental stick with the sharp (needle) you should use 998.2 (Accidental puncture or laceration during a procedure) as the primary ICD9 Codes. You should also report V15.85 (Exposure to potentially hazardous body fluids) as a supplementary code to further describe the circumstances of the accidental stick. Code V15.85 is one of several specific codes that describe exposure to such substances as lead asbestos and body fluids that have not yet caused illness.

Because this is a workers' compensation claim you should also report an ""E"" code to describe external causes of injuries or poisonings. E codes range from the common (E880.9 Fall on or from other stairs or steps) to the obscure (E847 Accidents involving cable cars not running on rails) and you should use them when you need to answer the question ""How did it happen?""

In this case you should report E920.5 (Accidents caused by cutting and piercing instruments or objects; contaminated needle or needle stick) as an additional supplementary code to describe the accident.

E codes do not change your reimbursement amount because they are ""for informational purposes only."" You should never report E codes in lieu of a diagnostic code to describe an injury but E codes help the insurer understand how the patient was injured - and that can make a big difference in a workers' compensation claim."