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Thread: It there too many codes?

  1. #1
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    Default It there too many codes?

    I was coding this: female presents to the ED with laceration of the wrist due to self inflicted knife wound. ED physician determines after discussion that the patient is suicidal. Her wound is 3.5 cm in length and he repairs the wound with sutures in a layered closure fashion. She is transferred to the local mental health clinic for additional treatment. and this is what I coded
    881.2, E956 and 86.59 I was unsure about that one. Can someone help. Thanks
    Last edited by codingchick; 08-03-2010 at 09:31 PM. Reason: Is not It

  2. #2

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    Quote Originally Posted by codingchick View Post
    I was coding this: female presents to the ED with laceration of the wrist due to self inflicted knife wound. ED physician determines after discussion that the patient is suicidal. Her wound is 3.5 cm in length and he repairs the wound with sutures in a layered closure fashion. She is transferred to the local mental health clinic for additional treatment. and this is what I coded
    881.2, E956 and 86.59 I was unsure about that one. Can someone help. Thanks
    Hi Codingchick,
    This is the manner in which I would code this information you provided:
    881.02, E956, 300.9(suicidal attempt), 12002; I would not use the Volume 3 procedure code, but I could be incorrect. Hope that helps you some. Don't you just love coding

  3. #3
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    Do not use the Volume 3 code for the procedure as that code is for inpatient only use. Er uses CPT codes for the procedures. Also the physician has not documented a nonpshychotic mental disorder so we cannot code it. The suicide attempt is covered by the E code so code only the wound (881.02) , the E code (E956), and the repair as 12032 since it is documented as a layered repair.

    Debra A. Mitchell, MSPH, CPC-H

  4. #4

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    I would code the 300.9 code even if the E code is used due to the fact that the physician documented or as you noted patient is suicidal; the E code in its self would describe the cause of injury, which is the wrist laceration, however, the 300.9 code in my opinion provides greater detail that the patient has tendecies or risk of suicide. As for the CPT procedure code I do agree after seeing the layered fashion technique that is 12032 2.6 to 7.5cm.

  5. #5
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    I sorry but I still must disagree, the coder may not make diagnosis decisions like that. The physician stated it was self inflicted and the patient is suicidal, there is no mention of a mental disease, nonpsychotic or psychotic. The E code states it is an attemted suicidal event. There is not enough documentation to support the use of the 300.9 code. Suppose the patient is psychotic or bipolar or has any other mental disease or maybe none at all. Maybe it is just a reaction to a one time event. There are too many unanswered issues so we can code only what we know.

    Debra A. Mitchell, MSPH, CPC-H

  6. #6
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    Question Thanks a million!!!

    Thank you Debra and Shadelw I was stuck on this one for a while. But what if it tells you not to use CPT only ICD then what?

  7. #7

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    Quote Originally Posted by mitchellde View Post
    I sorry but I still must disagree, the coder may not make diagnosis decisions like that. The physician stated it was self inflicted and the patient is suicidal, there is no mention of a mental disease, nonpsychotic or psychotic. The E code states it is an attemted suicidal event. There is not enough documentation to support the use of the 300.9 code. Suppose the patient is psychotic or bipolar or has any other mental disease or maybe none at all. Maybe it is just a reaction to a one time event. There are too many unanswered issues so we can code only what we know.
    I agree,we can only code what we know, and your rationale was helpful!

  8. #8
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    Quote Originally Posted by codingchick View Post
    Thank you Debra and Shadelw I was stuck on this one for a while. But what if it tells you not to use CPT only ICD then what?
    What are you coding for? Is this for a test or a real workplace issue? You never use volume 3 codes for physician or ER coding only inpatient. If this is for testing purposes then is sounds like they want only the diagnosis. However I do not think it is appropriate to post test questions on the forum.

    Debra A. Mitchell, MSPH, CPC-H

  9. #9
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    I would have to agree with Debra on this and only code the laceration and E code with the layered closure. But at our facility we are required to input the volume 3 procedure code so I would have that on there also

  10. #10
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    I would really have to question why you are using Volume 3 codes in the ER.

    Debra A. Mitchell, MSPH, CPC-H

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