Q: MVC with man trapped at the Left knee by the dashboard. Upon extrication he has gross deformity at the knee with large blood loss and no sensation or movement in the L lower leg, no pedal pulse. Diagnostics indicate open severely comminuted distal L femur fracture with all ligaments in disruption to the knee. There is also an open midshaft fracture of the left tibia. An above the knee amputation was done on day 2. Please code the L lower extremity injuries

Mar 1, 2012 | Head/Neck | 0 comments

A: Code the injury at the L knee as a crush injury at or above the knee code 813002.4, bone, soft tissue, vascular and nerve were all involved. You would also code the open L mid shaft tibia fx even though the leg was amputated this was still an injury

Q: Scenario: Man falls from a ladder while trimming a tree striking the upright post of a mental fence before impact on the ground. 1. Deep 18cm laceration across the abdomen with obvious evisceration of bowel. Exploratory Lap report only describes a 2. serosal tear at the junction of the duodenum and jejunum with a small hematoma. How would you code these injuries?

Jan 1, 2012 | Chest, External, Extremities, Head/Neck | 0 comments

A: Cannot code evisceration, code the abdomianl laceration as minor laceraton < 20 cm 510602.1, code serosal tear assign to jejunum as partial thickness injry 541422.2 hematoma is part of this injury, Lis Franc injury is a dislocation of tarsometatarsal joints with no mention of fracture, cartilage involvement or ligament injury so code 878030.1

Q: A child is admitted to the ED after playing on the trampoline where another child landed on him. Xrays are done and a navicular fracture is identified. Please code this injury

Nov 2, 2011 | Head/Neck | 0 comments

A: This fracture requires more information as to whether or not this is a tarsal or a carpal bone; In an actual clinical situation, the physical examination and xray would b labeled as wrist or foot; If this is a tarsal navicular fx then the appropriate code would be 857451.2; if this is a carpal

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Q: A trauma activation is called for a patient with a GSW to the lower abdomen. Immediate laparotomy is undertaken and a perforation to the sigmoid colon identified. The sigmoid is resected, colostomy placed, and the patient moves to the ICU. Please code this abdominal injury

Sep 1, 2011 | Head/Neck | 0 comments

A: The sigmoid is part of the colon and therefore coded to the “colon” in the abdomen chapter. A perforation is identified. The injury should not be coded any more severely just because the sigmoid was resected. Code:540824.3

Q: Patient arrives after a fall down a flight of outdoor stairs. The patient experiences an unknown period of exposure prior to being found and brought to the ED. The initial core temperature on arrival is 90.1 degrees Fahrenheit; What would you do with this information?

Jun 1, 2011 | Head/Neck | 0 comments

A: A tempreature of 90.1F is equivalent to a temperature of 32.3 C and therefore meets criteria for the hypothermia code 010004.2; this is not induced for medical treatment but rather from exposure and is included as an injury.

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