General Surgery Coding Alert
Gunshot Wound
Nebraska Subscriber
Answer: Two distinct codes may be used because the gunshot affected two sites, the stomach and the jejunum, says Kathleen Mueller, RN, CPC, CCS-P, a general surgery coding and reimbursement specialist in Lenzburg, Ill. For the stomach repair, code 43840 (gastrorrhaphy, suture of perforated duodenal or gastric ulcer, wound or injury) should be used, and 44602 (suture of small intestine [enterorrhaphy] for perforated ulcer, diverticulum, wound, injury or rupture; single perforation) should be used for the repair of the jejunum.
In this case, Mueller says, two distinct injury codes should be used: 863.1 (injury to gastrointestinal tract, stomach, with open wound into cavity) and 863.39 (injury to gastrointestinal tract, small intestine, with open wound into cavity, other). List 43840 first on the claim form because it has more relative value units (20.30) than 44602 (18.52).
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