Injury icd 9 codes

mrolf

Guru
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West Point, Nebraska
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We are having a conflict on coding for injuries. When the physician states on the charge ticket a diagnosis of "ankle pain due to slipping on the ice yesterday" some of the coders feel you have to put diagnosis of ankle pain with E codes. Some insurance companies only look at the first diagnosis code. This then would not be considered an injury because ankle pain would be 719.47 and is not a 800 or 900 code which are considered injury codes. Some feel we could use code 959.7 (ankle injury) as first dx code and 719.47 and then E codes, therefore the insurance companies would then view this as a accident. Some insurance companies pay 100% on injuries. We did have a patient with this scenario (insurance pays 100% on injuries, however it was not coded as an injury, therefore went to insurance deductible. unhappy patient) What are your thoughts on this. Would like to have a good answer to provide to the coders. Thanks.
 

mitchellde

True Blue
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Columbia, MO
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I agree with the 959.7, or if the physician documents the pain is acute you can use 338.11 as the first code. Either way I agree that the 719.47 is the worst choice for a first listed code you need a code to indicae the trauma, then you can use the 719.47 to indicate the body area and the E code last for the cause.
 
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