Q: A patient sustains a basilar skull fracture, fractured L zygoma and a nasal fracture. She has bilateral periorbital ecchymosis. There is no mention in the chart of cerebral spinal fluid (CSF) leak. How would you code the basilar skull fracture?

A: The correct code is 150202.3. If the patient has a CSF leak, the treating physician(s) will always mention it in the chart. When there is no mention of CSF leak, the coder may use the “without CSF leak” code. The periorbital ecchymosis could be due to the nasal fracture and is not necessarily a sign of bleeding from the base fracture.