Wiki Need Correct Coding for a dx of a cat bite, finger

What ICD-9 would you use for bite, cat, finger - no open wound mentioned in Hx or PE

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chief1kee

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I am convinced, that a animal bite is an open wound, without having to be stated as open and would code a cat bite of finger with 883.0.

However, after discussion with another coder, she always uses contusion, unless the physician documents that it was an open wound and would code a cat bite of finger 923.3.

I have been unable to convince her to where she is comfortable with the open wound ICD-9 even after looking up the definition. Following is my reasoning as to why it should be considered an open wound.
1. The definition of a bite from Tabers medical dictionary states; " 1. To cut with teeth. 2. An injury in which the body surface is torn by an insect or animal, resulting in abrasions, punctures, or lacerated wounds. 3b. Specific for cat. A wound inflicted by the teeth of a cat; typically a puncture wound on the hand or the arm."

2. Since the medical definition states an open wound, it would then put the resposibility of the physician to state the the skin was intact to change the normal definition. Not the other way around.


The ICD-9 book only states Bite(s), animal - see Wound, open, by site
intact skin surface - See Contusion.

Please give me feedback good enough to be able to convince the other coder or correct me if I am wrong.
 
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Cat bite - open vs closed

I have always erred on the side of caution and never code it as an open wound unless the dictation clearly states that the skin was broken. I am a firm believer in, "when in doubt, leave it out"..."if they don't say it, we can't know it". I always imagine sitting in the witness box, being sworn in and being asked, "where does it say that the bite broke the skin?" I like life on the outside and don't plan going on the inside if I can help it.

Joyce
 
ICD9 pretty clear

I agree with Joyce. ICD9 is pretty clear on this ... if there is no mention of an open wound then you have intact skin so you code from the contusion area.

F Tessa Bartels, CPC, CEMC
 
I agree too I have had children bitten befor and there was no break in the skin just a brusing with indentations so I would not begin to assume it was an open wound. Now if he documents that sutures were applied then you might have an argument.
 
AuntJoyce said:
I have always erred on the side of caution and never code it as an open wound unless the dictation clearly states that the skin was broken. I am a firm believer in, "when in doubt, leave it out"..."if they don't say it, we can't know it". I always imagine sitting in the witness box, being sworn in and being asked, "where does it say that the bite broke the skin?" I like life on the outside and don't plan going on the inside if I can help it.

Joyce
Click to expand...

Nicely said...
 
Without documentation stating an open wound, I like 959.5 becuase it states "injury other and unspecified". A contusion is a bruise which is also not stated with the information provided in the question.
 
I agree with Lisa. I vote for the 959.5 plus and E code to reflect the cat bite. I think if a cat bit hard enough to leave a bruise, more than likely it would break the skin??
 
959.5 plus obviously E codes. You cannot code for open wound if there is not one documented and you cannot code for a contusion if there is not one documented... the only choice you have left is 959.5
 
i will go with 883.0 because icd book lead only wound ..if the physician not documented the condition of the skin .
 
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