The Angel Of the South
Networker
This was in AAPC practicode. The relevant part of the clinical impressions said: Multiple contusions to the front wall of chest: So my ICD-10 code for that was supposed to be: S20.219A--"contusion of unspecified front wall of thorax."
If I went only by the clinical impressions, that would have been obvious. But there was more documentation. The physical exam said: "Chest wall contusions injury: mild tenderness located in the right, central and anterior chest." So I thought the contusion was specified; I thought it actually included both the right wall and central wall." So I submitted two S codes: S20.211A (for right front wall) and S20.214A (for middle front wall), and got them counted wrong. Did the "mild tenderness" not count for the contusion?
Also, because the report said the pt was driving a sedan and collided with a van head-on, I submitted V43.54XA for "Car driver injured in collision with van in traffic accident." The rationale ignored this in the coding. I'm not sure why. The pt also had a left knee contusion, and I coded that one correctly. The rationale gives only two codes in the answer: S20.219A, S80.02XA.
If I went only by the clinical impressions, that would have been obvious. But there was more documentation. The physical exam said: "Chest wall contusions injury: mild tenderness located in the right, central and anterior chest." So I thought the contusion was specified; I thought it actually included both the right wall and central wall." So I submitted two S codes: S20.211A (for right front wall) and S20.214A (for middle front wall), and got them counted wrong. Did the "mild tenderness" not count for the contusion?
Also, because the report said the pt was driving a sedan and collided with a van head-on, I submitted V43.54XA for "Car driver injured in collision with van in traffic accident." The rationale ignored this in the coding. I'm not sure why. The pt also had a left knee contusion, and I coded that one correctly. The rationale gives only two codes in the answer: S20.219A, S80.02XA.
