Home Health ICD-9/ICD-10 Alert

To help ensure you select the right code for your patient’s wound, make sure to ask the following questions:

Was the open wound a result of a trauma/injury? If so, you can report it as an open wound with a code from 870-897 (Open wounds).

Was the wound an outcome of surgery with post-operative issues with wound? Code to complications of procedures, 998.xx, if the physician states or confirms the complication and documents the cause and effect between the surgical care and the dehiscence.

Is the wound an ulcer? Look to the appropriate code range for the ulcer type:

• Pressure ulcer: 707.00-707.09 plus Stage 707.2x
• Stasis ulcer (venous insufficiency) 459.81 and 707.10-707.19
• Stasis ulcer (due to venous hypertension, idiopathic) 459.31 or 459.33
• Stasis ulcer (due to venous hypertension due to deep vein thrombosis) 459.11 or 459.13
• Diabetic ulcer: 250.80 and 707.10-707.19
• Lower extremity ulcer: 707.10-707.19
• Arterial or ischemic ulcer: (Atherosclerosis of the extremities with ulcer): 440.23 plus 707.10-707.9
• Arterial or ischemic ulcer with gangrene (Atherosclerosis of the extremities with gangrene): 440.24 plus 707.10 -707.19.

Is the wound an abrasion, blister, nonvenomous bug bite, or superficial injury, other or unspecified? Look to codes from 910 to 919. Coders often confuse skin tears as open wounds, but if the flap is present over the wound, then you should use a superficial code. This category includes individual codes for infected wounds and those superficial injuries that are without mention of infection.

A common tool to determine if a skin tear is an open wound or superficial wound is based on the Payne-Martin Classification system for skin tears.

Category 1. (Code as 910-919)

• Skin tear without tissue loss.
• Linear type: Epidermis and dermis have been pulled apart.
• Flap type: Epidermal flap completely covers the dermis to within one mm of the wound margin.

Category 2. (Code as 910-919)

• Skin tears with partial tissue loss.
• Scant tissue loss, 25 percent or less of the flap is lost.
• Moderate to large tissue loss: More then 25 percent of the epidermal flap is lost.

Category 3. (Code to open wound 870-897)

• Skin tear with complete tissue loss.
• Epidermal flap is missing.