ED Coding and Reimbursement Alert

Question: A 36-year-old patient with diabetes presented to the ED noting that she had dropped a knife on her right pinky toe, cutting the top of her toe while chopping carrots. She waited two days before coming into the ED. The physician evaluated her swollen, red, and painful toe, which had pus coming from it. The patient did not sustain damage to her toenail, and there was no foreign body in the wound. The ED physician took a culture of the laceration, and the result from the lab came back as a staph infection. Which ICD-10 codes should we report?

Texas Subscriber

Answer: You should report S91.114A (Laceration without foreign body of right lesser toe(s) without damage to nail, initial encounter) for the laceration, along with the proper ICD-10 code such as B95.8 (Unspecified staphylococcus as the cause of diseases classified elsewhere) for the staph infection. You should also report W26.0XXA (Contact with knife, initial encounter) as the external cause code.