Pediatric Coding Alert

Question: What is the correct diagnosis code for a nursemaid's elbow? We are using ICD9 832.00 .


Connecticut Subscriber

Answer: You should use a more specific fifth-digit subclassification. Nursemaid's elbow involves an anterior subluxation, according to the National Center for Emergency Medicine Informatics. Therefore, you should assign a fifth digit of 1 for an anterior elbow dislocation, instead of the unspecified fifth-digit subclassification of 0.

Good idea: Update your superbill to contain 832.01 (Dislocation of elbow; closed dislocation, anterior dislocation of elbow), rather than 832.00 (... elbow unspecified). Educate your charge-entry personnel to mark code 832.01 for 24640 (Closed treatment of radial head subluxation in child, nursemaid's elbow, with manipulation).

Answers to You Be the Coder and Reader Questions provided by Richard A. Molteni, MD, FAAP, a neonatologist and medical director at Children's Hospital and Regional Medical Center in Seattle; Victoria S. Jackson, administrator at Southern Orange County Pediatric Association in Lake Forest, Calif.; Charles A. Scott, MD, FAAP, pediatrician at Medford Pediatric & Adolescent Medicine PA in New Jersey; Richard H. Tuck, MD, FAAP, a pediatrician at PrimeCare of Southeastern Ohio; and Sherry Wilkerson, RHIT, CCS, CCS-P, coding and compliance manager at Catholic Healthcare Audit Network in Clayton, Mo.