help with diagnosis and sequencing


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Patient presesnts to ED via EMS for complaint of bleeding from surgical site/JP drain. Per husband, he was cleaning around the drain when blood started "pouring out" into the JP drain and from around the drain site. Patient's husband reports patient had surgery 4 weeks ago for ulcers and intestinal obstruction, developed an infection post-op and had the drain placed. Patient reports abdominal pain (constant, severe, sharp, throbbing, radiating from near surgical site).

ER physician diagnoses abdominal pain, right lower quadrant; abdominal pain, right upper quadrant,; upper GI bleed; postoperative infection.

Should this be coded as 338.18, 578.9, 998.59?