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

Voters
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  • 883.0

    7 43.75%
  • 923.3

    3 18.75%
  • 959.5

    7 43.75%
Multiple Choice Poll.
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Thread: Need Correct Coding for a dx of a cat bite, finger

  1. #1
    Join Date
    Apr 2007
    Location
    Daytona Beach
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    8

    Red face Need Correct Coding for a dx of a cat bite, finger

    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.
    Last edited by chief1kee; 11-18-2009 at 07:09 AM. Reason: Added My reasoning for this to be an open wound

  2. #2

    Thumbs up 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

  3. #3
    Join Date
    Apr 2007
    Location
    Milwaukee WI
    Posts
    4,453

    Default 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

  4. #4
    Join Date
    Apr 2007
    Location
    Columbia, MO
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    11,892

    Default

    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.

    Debra A. Mitchell, MSPH, CPC-H

  5. #5
    Join Date
    Apr 2007
    Location
    North Carolina
    Posts
    3,128

    Thumbs up

    Quote Originally Posted by AuntJoyce View Post
    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
    Nicely said...

  6. #6
    Join Date
    Apr 2007
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    Greeley, Colorado
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    2,046

    Default

    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.
    Lisa Bledsoe, CPC, CPMA

  7. #7
    Join Date
    Apr 2007
    Location
    Phoenix, AZ
    Posts
    621

    Default

    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??
    Cyndi Allen, CPC, CIRCC
    2015 Local Chapter President, Casa Grande, AZ

  8. #8

    Default

    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

  9. #9
    Join Date
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    Default 883.0

    I will go with 883.0
    Thanks
    Thyagarajan Munuswamy CPC CCS

    "Man needs his difficulties because they are necessary to enjoy success".
    ABDUL KHALAM - Former President of INDIA

  10. #10

    Default

    Quote Originally Posted by +91 9035691119 View Post
    I will go with 883.0
    How do you come up with 883.0?

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