# Blunt Trauma - Abd



## Coder Bradley (Jul 9, 2010)

Running into an issue with coding this one.  

Patient fell from a ladder, landing directly on his back and side.  He complains of left sided lower back pain as well as left sided abdominal and flank pain.  No N/V hematuria etc.  

Provider gives a diagnosis of blunt abdominal trauma, I wasn't sure how to code that since he did not specify internal organ damage as well.  I thought 959.19 or 959.12 with the abd. pain codes, coworker felt that didn't apply.  
Any suggestions?


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## vj_tiwari (Jul 13, 2010)

Hey,

I think 959.12 and E881.0 is the appropriate coding for this.

Please refer following notes ... Hope this helps! 

In medical terminology, blunt trauma, blunt injury, non-penetrating trauma or blunt force trauma refers to a type of physical trauma caused to a body part, either by impact, injury or physical attack; the latter usually being referred to as blunt force trauma. The term itself is used to refer to the precursory trauma, from which there is further development of more specific types of trauma, such as concussions, abrasions, lacerations, and/or bone fracturing. Blunt trauma is contrasted with penetrating trauma, in which an object such as a bullet enters the body.

Blunt abdominal trauma is often referred to as the most common type of trauma, representing around 50 to 75 percent of blunt trauma. The majority of BAT is often attributed to car-to-car collisions, in which rapid deceleration often propels the driver forwards into the steering wheel or dashboard, causing contusions in less serious cases or rupturing of internal organs due to briefly increased intraluminal pressure in more serious cases where speed or forward force is greater. A growing trend reflects inexperienced BMX enthusiasts attempting turbo-level tricks such as 360 degree handlebar rotations. An incomplete handlebar rotation (such as one that is 270 degrees, and not a full rotation) may result in BAT, most commonly to the splenic flexure of the large intestine.

Abdominal trauma caused by deceleration and impact shows a similar effect to trauma to any other part of the body; namely the rupturing or damage of free and relatively fixed objects, a classic example of such an injury would be a hepatic tear along the ligamentum teres followed with injuries to the renal arteries.

As with most trauma, blunt abdominal trauma is often the cause of further injury, depending upon the severity of the accident. In the majority of cases, the liver and spleen (see Blunt splenic trauma) are most severely affected, followed by damage to the small intestine. Recent studies utilizing CT scanning have suggested that hepatic and other concomitant injuries may develop from blunt abdominal trauma.

In rare cases, BAT has been attributed to several medical techniques such as the Heimlich Maneuver, attempts at cardiopulmonary resuscitation, and manual thrusts to clear an airway. Although these are rare causes of blunt abdominal trauma, it is often thought that they are caused by applying unnecessary pressure when administering such techniques.

Among equestrians with BAT, common causes include kicks from the horse and the horse falling on top of its rider.

VJ.


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## Coder Bradley (Jul 14, 2010)

Very helpful, thak you!


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## jodismith (Jul 14, 2010)

Wow--great examples!


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