Primary Care Coding Alert

Stumped about how to code that paintball injury or scooter fall? The ICD-9 revisions have the answers.

Now that those razor scooters are so popular, FPs can use E885.0 (Fall from [nonmotorized] scooter) as a supplementary code when treating injuries resulting from such falls.

And another sport rising in popularity paintball now has its own code, E985.7 (Injury by firearms, air guns and explosives, undetermined whether accidentally or purposely inflicted; paintball gun).

"The E codes are supplemental codes, meaning they are not typically used for the primary diagnosis," says Kent Moore, manager of Health Care Financing and Delivery Systems for the American Academy of Family Physicians in Leawood, Kan. If a child falls off a scooter and breaks his or her arm, use the appropriate fracture care code and report the E code in addition as a means of explaining the accident.

Toxic shock syndrome, which mainly affects women, can now be specifically identified with 040.82 (Toxic shock syndrome). Previously, coders had to use 040.89 (Other specified bacterial diseases; other). You will need to use an additional code to identify the organism causing the toxic shock, Moore says.

ICD-9 also created a code for West Nile fever, 066.4 (West Nile fever). Relatively new to the United States, the West Nile virus is an encephalitis transmitted by mosquitoes. The code includes West Nile encephalitis, West Nile encephalomyelitis, and West Nile virus. Previously, viral West Nile fever had been coded using 066.3 (Other mosquito-borne fever).

Unfortunately, the events of Sept. 11 have even affected coding. ICD-9 added several new codes under a whole new category of E-codes labeled "Terrorism":