Question: Our elderly patient was mowing his lawn and ran over a wire hanger. The hanger penetrated his calf above the Achilles tendon, but he pulled it out and kept mowing. Three days later the wound was infected and necrosed. He had surgery to clean up and close the laceration. How should we code for this patient? Answer: Code for this patient as follows: You are providing aftercare following the patient's surgery to repair a traumatic wound, so V58.43 is your principal diagnosis. Because you have listed a V code that replaces a Skin 1 case mix code for a traumatic wound, it's appropriate to list that code in M1024 for potential additional points. The patient's wound hasn't yet healed, so you can also code for it in M1022. If the wound were complicated you would code for it with: M1020a: 891.1 (Open wound of knee, leg [except thigh], and ankle; complicated). In this case, the complication code would trump the use of a V code, so there would be no need to complete M1024.