# ICD-10 what is the correct way to code the question below?



## dmgomez (Mar 20, 2014)

Sepsis due to puncture wound of the lower back and pelvis without a foreign body, initial encounter.


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## vhinton (Mar 20, 2014)

Per ICD-10 coding guidelines Sepsis for a diagnosis of sepsis, assign the appropriate code for the underlying systemic infection. If the type of infection or causal organism is not further specified, assign code A41.9, sepsis unspecified organism. S31.03A is puncture wound without foreignbody of lower back & pelvis


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## dmgomez (Mar 21, 2014)

*thank you for your help!*

so the sepsis code would be first then the puncture secondary correct?


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## YoseJenn (Mar 24, 2014)

Would you not code the puncture wound part of it with an S in 7th position since the sepsis is a result of the puncture wound?


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## dmgomez (Mar 25, 2014)

are you talking sequela? It states initial.


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## mitchellde (Mar 25, 2014)

I am confused, how could you have sepsis already develope at the initial encounter for an acute injury?  The initial encounter does not apply to the physician visit it applies to the patient, is this the patient's initial encounter for active initial treatment of the injury.  Or has the injury been previously treated and has now developed sepsis.  If so then even if this provider is seeing the patient for the 1st time this is sequela.  The scenario needs more information.


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## mjb5019 (Mar 25, 2014)

*Sepsis*

The scenario doesn't say the pt is presenting with the acute injury- my read is the pt presented with sepsis (due to a puncture wound) initial encounter.


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## mitchellde (Mar 25, 2014)

Then it could not be initial for the dx, it would be seguela.  Sepsis would not be present when the patient presented with the acute wound for active treatment.


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## dmgomez (Mar 28, 2014)

apparently there are more questions to this question. it was a question on our book that we took our test to keep our certification. Really I guess what I need to know most is if Sepsis can be coded primary. I am talking unspecified sepsis.


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## laurenl247 (May 22, 2014)

According to the Official ICD-10 CM Draft Guidelines (C.1.d.6) that a non
infectious process may lead to an infection, resulting in sepsis. If the condition meets the definition for the first listed diagnosis the code for the non -infectious condition should be sequenced first, followed by the
code for the resulting infection.

so the answer would be :  S31.030A, A41.9


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