Q: How would the following be coded and scored? L rib disarticulations … Per autopsy report: “On the left, ribs 2, 3, and 4 are hypermobile medially and apparently dislocated from their vertebral articulations. No fractures are palapable or evident.”

A:Thanks to Jody and Terri for participating in our online discussion. One of the difficulties for those who are experienced in ICD 9 coding is that AIS and ICD 9 just don’t always work the same way. As Jody noted, there are no AIS codes for rib dislocations, and Terri’s spine code is used for a thoracic spine injury, not a rib injury. Disarticulation of the rib at its connection to the thoracic spine is treated as a rib fracture, so the correct code in AIS 98 is 450220.2. In AIS 2005 one of several changes in the Thorax chapter includes this code, which changes to 450203.3.