ED Coding and Reimbursement Alert

Have the telltale indications on hand with this clip-and-save list

Children (and their parents) may present to the ED  with explanations of injuries that don't add up. Refer to this handy list of abuse symptoms when something looks fishy.

Physical abuse:

   Unexplained injuries, such as burns (e.g., 943.21, Burn of upper limb, except wrist and hand; blisters, epidermal loss [second degree]; forearm), bites (e.g., 882.0, Open wound of hand except finger[s] alone; without mention of complication), bruises (e.g., 922.31, Contusion of trunk; back), broken bones (e.g., 821.01, Fracture of other and unspecified parts of femur; shaft or unspecified part, closed; shaft), and black eyes (921.0, Black eye, not otherwise specified)

   Healing bruises or contusions (especially after an absence from school)
   Frightened of parents 
   Objects when it's time to go home
   Cowers at the approach of adults.

Emotional abuse:

   Shows behavioral extremes, such as being overly compliant or demanding, extreme passivity, or aggression
   Inappropriately adult or child-like
   Delayed physical or emotional development
   Attempted suicide
   Lack of attachment to the parent(s).

Sexual abuse:

   Nonspecific symptoms, such as sleep disturbances (e.g., 780.50, Sleep disturbance, unspecified), nightmares, phobias, abdominal pain (e.g., 789.0x, Abdominal pain), sudden change in appetite, difficulty walking or sitting, or refuses to change for gym or participate in physical activities
   Developmentally unusual sexual behavior
   Rectal (569.3) or genital (623.8) bleeding
   Contracts a sexually transmitted disease (e.g., 098.0, Gonococcal infections; acute, of lower genitourinary tract)
   Becomes pregnant.