Wiki Cause of Injury Code?

veloso

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Hi,
Anyone please assists!

Chief complaint; Pt. with' wound in the left upper arm with pus from flu vaccine injection site

My Primary code; S41.102AA open wound left upper arm

but needs Cause of Injury for additional code???


Thank you,
IM
 
I would not use the S41 series codes because this is not a traumatic wound or injury - it appears to be a complication of the vaccination procedure. Did the provider not give a diagnosis beyond this (e.g. infection of vaccine site)?

If this is all you have to go on, I would assign T81.89XA - other complications of procedures, not elsewhere classified. For an external cause code, you can assign Y84.8 - other medical procedures as the cause of abnormal reaction of the patient....
 
Hi, the provider did give Dx. T17.8XXA and did not mention of any complication but will go with your given diagnosis.

Thanks a lot for the help, have a Happy Holidays!
 
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