Wiki Need help with procedure for subungual hematoma of thumb

[JulesofColorado]

I have a patient who came into the ER for subungual hematoma of the thumb.

The procedure that was done is Betadine x3 was used prior to electrocautery and trephination. Serosanquineous fluid was released. The thumb was wrapped in tube gauze bandage with a cage applied for comfort and protection of the thumb.

The closest I came up with for the procedure codes are I&D codes 10140 for the CPT and 860.4 for the ICD-9 procedure.

Any input would be appreciated.

Thanks

 

[jccoder]

We use 11740 Evacuatioin of subungual hematoma.

 

[LTibbetts]

The 11740 would be the correct code. The only difference being that the definition for "subungual" is under the nail, and the 10140 is for just under the skin. The 860.4 is a little off though, I would use 923.3 plus an E code since hematoma's usually code to contusions and this one is defined as contusion-finger(nail)(subungual)

 

[JulesofColorado]

Thank you so much! I haven't done a lot of procedure coding so am still in learning stages.

 

[JulesofColorado]

Using 3M though I come up with 11740 and 86.04.

 

[LTibbetts]

Oh, I'm sorry, you meant 86.04 procedure code and I thought you meant Dx code...oops. I only use ICD procedure codes for inpatient accounts here so I didn't even try to find that one. I'm sure you are right about the 86.04

 

[mitchellde]

That one got us both! I thought he meant dx code also! So I was agreeing with you, Leslie. When I coded outpatient using 3M I turned off the ICD-9 locator for procedures so that they would not come up as it was just a lot of extra work.

 

[LTibbetts]

Me too, and thanks for the back up

 

[JulesofColorado]

No need to be sorry I really appreciate all of your help! Thank you for all of your help!

 

[Tanna717]

electrocautery device??

Has anyone billed for the actual device used for this procedure?