Neurosurgery Coding Alert

Question: Encounter notes indicate that a patient suffered from a crushing injury to their face. The physician performed a complete skull X-ray to examine the patient’s injury. How should I report the diagnosis for this encounter?

Answer: The code for the X-ray is 70260 (Radiologic examination, skull; complete, minimum of 4 views). Your ICD-10 code choice, however, requires more information.

To find the most accurate diagnosis code, do this:

Check with the provider, or in the notes, to see which part of the face the crushing injury affected.

Check the patient record to mark the type of encounter this is for the crushing injury: initial, subsequent, or sequalae.

Then, report one of the following codes for the crushing injury:

• S07.0XXA (Crushing injury of face, initial encounter)
• S07.0XXD (… subsequent encounter)
• S07.0XXS (… sequela)
• S07.1XXA (Crushing injury of skull, initial encounter)
• S07.1XXD (… subsequent encounter)
• S07.1XXS (… sequela)
• S07.8XXA (Crushing injury of other parts of head, initial encounter)
• S07.8XXD (… subsequent encounter)
• S07.8XXS (… sequela)
• S07.9XXA (Crushing injury of head, part unspecified, initial encounter)
• S07.9XXD (… subsequent encounter)
• S07.9XXS (… sequela)

X-planation: So, what’s up with all the Xs? These are placeholders; since the encounter type is always a 7th character in an ICD-10 code, you need placeholders when the ICD-10 codes come up short. That’s where the Xs come in. According to ICD-10 instructions for S07.0 through S07.9: “Additional 7th Digit Required with place holder X.”