Orthopedic Coding Alert

Question: We recently saw a workers- compensation patient who had traumatic neuritis of the thumb. The patient was repetitively using a drill and developed a lump on his thumb that caused the problem. Which ICD-9 code is appropriate?


Massachusetts Subscriber

Answer: If the patient is new to your practice, you should report the diagnosis code for the presenting problem first, which is 955.6 (Injury to peripheral nerve[s] of shoulder girdle and upper limb; digital nerve), followed by the E codes to describe how the injury occurred. In this case, you-ll report E927 (Overexertion and strenuous movements) and E849.3 (Industrial place and premises).

On subsequent claims, you will probably only need to report 955.6, but every workers- compensation payer maintains its own regulations, so be sure to ask your insurer whether they prefer E codes on every claim.