ICD 10 Coding Alert

General Surgery:

S21.1_ Adds Detail Beyond 876.0 for Back Wounds

Published on Thu Dec 06, 2012

Laceration, puncture, and more expand codes.

Coding wound closure requires identifying wound characteristics, and that will become a lot more specific when you change from ICD-9 to ICD-10.

Remember: CMS has finalized the ICD-10 implementation date for Oct. 1, 2014, delaying the action one year from the original deadline.

Distinguish Wound Type for ICD-10 Detail

Although ICD-9 and ICD-10 contain a host of codes for reporting wounds based on body site, we'll focus on wounds of the back to illustrate the level of detail you can expect with the code-set change.

ICD-9 provides just one code for uncomplicated open back wound that doesn't penetrate the thoracic cavity -- 876.0 (Open wound of back without mention of complication).

ICD-10 greatly expands your code choices by specifying the wound type, as follows:

S21.20 -- Unspecified open wound of back wall of thorax without penetration into thoracic cavity

S21.21 -- Laceration without foreign body of back wall of thorax without penetration into thoracic cavity

S21.22 -- Laceration with foreign body of back wall of thorax without penetration into thoracic cavity

S21.23 -- Puncture wound without foreign body of back wall of thorax without penetration into thoracic cavity

S21.24 -- Puncture wound with foreign body of back wall of thorax without penetration into thoracic cavity

S21.25 -- Open bite of back wall of thorax without penetration into thoracic cavity.

Add Location Specificity with Extra Digit

Wound type isn't the only increased specificity you'll have with ICD-10. The codes will also allow you to locate the wound more specifically.

Sixth digit: Each of the preceding codes requires an additional digit that specifies the following information as a descriptor of the back wall of thorax:

1 -- right

2 -- left

9 -- unspecified.

Example: The definition for S21.231 is "Puncture wound without foreign body of right back wall of thorax without penetration into thoracic cavity."

Caution: If the open wound involves the lower back and pelvis, you'll need to look to a different code family in ICD-10: S31.0 (Open wound of lower back and pelvis). Extended codes add similar detail about the wound type, like puncture, laceration, etc.

ICD 10 Coding Alert

PCS:
Your Provider's Transfusion Notes Must Specify Body Part, Approach, Substance, and Qualifier
Check out how many PCS options you have without detailed information. Notes describing the simple [...]

Documentation:
Gastric Ulcers Morph to K25 in ICD-10
Observe minor changes to list of inclusions and exclusions. When you report gastric ulcer diagnoses [...]

Diagnosis Spotlight:
ICD-10 Amplifies Nontraumatic Subarachnoid Hemorrhage Choices
Pay attention to site and side of the hemorrhage. You may find it confusing to [...]

Ob-Gyn:
Jump to O24.4-- Codes for Gestational Diabetes in ICD-10
If the gestational diabetes is treated with both diet and insulin, code this. Gestational diabetes [...]

General Surgery:
S21.1_ Adds Detail Beyond 876.0 for Back Wounds
Laceration, puncture, and more expand codes. Coding wound closure requires identifying wound characteristics, and that [...]

Oncology:
282.62's Counterparts Specify Sickle Cell Crisis Types
Choose among 3 options when the code set changes. When sickle cell anemia results in [...]

You Be the Coder:
Join the Search for Jones Fracture Code
Question: A physician in my practice listed Jones fracture as the patient’s diagnosis, but I [...]

Reader Question:
Locate Your Leukorrhea Code In the ICD-10 Manual
Question: How should I report leukorrhea in ICD-10? Florida Subscriber Answer: Leukorrhea becomes a little [...]

View All