Primary Care Coding Alert

Question: The FP treated a patient who had been in a minor motorcycle accident (the patient was the passenger, and the motorcycle hit a parked car at low speed). The patient complained of jaw pain, and the notes indicate a diagnosis of mandibular deviation. What diagnosis code(s) do I need to include? Is this injury considered abnormal jaw closure (524.51)?

Minnesota Subscriber

Answer: Not exactly. When a patient has difficulty chewing or biting food, he may have abnormal jaw closure, which you would represent with 524.51 (Abnormal jaw closure).

Based on the notes you describe, however, there is a more specific diagnosis code for the patient. Because the physician documented "mandibular deviation," the better diagnosis for this patient would be 524.53 (Deviation in opening and closing of the mandible).

Remember: In addition to 524.53, report E812.3 (Other motor vehicle traffic accident involving collision with motor vehicle; passenger on motorcycle) to represent the cause of the patient's injuries.