allaire_s
Contributor
After reaching out to AAPC, I was given a permission to discuss the workbook cases in the forum. If you have the book, it is the case#49.
CC: Painful toe with progressing cellulitis.
DX: Acute osteomyelitis.
H/P: This gentleman by history stepped on a nail while working at the construction site some weeks ago and developed a cellulitis infection of the right foot, particularly at the area of the fifth toe. He as placed on IV antibiotics, wound care, and elevation. However, this progressed to abscess and irretrievable ischemia of the right fifth toe. He comes no for amputation of it.
What would you code for diagnoses?
I agree with AAPC using the Osteomyelitis code M86.171, but have a hard time with the sequela injury codes. Per answer key, S91.134S would be added as the cause of the infection. Plus, W45.0xxA would be added for the external cause.
Two issues: is this a late effect? A nurse practitioner reviewed this note and did not feel that a physician had documented a link between the two, plus added that the osteomyelitis could have been caused by other than the puncture.
Why was the seventh character A used for the external cause code if it is a sequela?
Looking forward to your comments! Thanks!
CC: Painful toe with progressing cellulitis.
DX: Acute osteomyelitis.
H/P: This gentleman by history stepped on a nail while working at the construction site some weeks ago and developed a cellulitis infection of the right foot, particularly at the area of the fifth toe. He as placed on IV antibiotics, wound care, and elevation. However, this progressed to abscess and irretrievable ischemia of the right fifth toe. He comes no for amputation of it.
What would you code for diagnoses?
I agree with AAPC using the Osteomyelitis code M86.171, but have a hard time with the sequela injury codes. Per answer key, S91.134S would be added as the cause of the infection. Plus, W45.0xxA would be added for the external cause.
Two issues: is this a late effect? A nurse practitioner reviewed this note and did not feel that a physician had documented a link between the two, plus added that the osteomyelitis could have been caused by other than the puncture.
Why was the seventh character A used for the external cause code if it is a sequela?
Looking forward to your comments! Thanks!