ED Coding and Reimbursement Alert

Question: Encounter notes indicate the ED physician treated a patient with a puncture wound in their cheek/ temporomandibular area. How should I choose an ICD-10 code for this injury?

Texas Subscriber

Answer: You’ll need to find out whether the wound contained a foreign body and, if possible, the laterality of the injury.

Go back to the notes and check on both of these elements. Then, choose from the following ICD-10 codes for your claim:

• S01.431A (Puncture wound without foreign body of right cheek and temporomandibular area, initial encounter)
• S01.432A (Puncture wound without foreign body of left cheek and temporomandibular area, initial encounter)
• S01.439A (Puncture wound without foreign body of unspecified cheek and temporomandibular area, initial encounter)
• S01.441A (Puncture wound with foreign body of right cheek and temporomandibular area, initial encounter)
• S01.442A (Puncture wound with foreign body of left cheek and temporomandibular area, initial encounter)
• S01.449A (Puncture wound with foreign body of unspecified cheek and temporomandibular area, initial encounter)

Last best option: If you’re unable to locate evidence of an FB or laterality of the procedure, your most accurate option would be S01.439A.