Wiki ICD-10 complication due to old injury Help

[browncpc]

patient with previous pins put in foot due to broken foot; now has wound on anterior foot (thinks pin is coming through)

There are postoperative changes of prior arthrodesed is of the tarsal and first and second tarsometatarsal joint with 3 fully threaded screws. There is mild peri-metallic lucency about the screws measuring up to 1.5 mm. The screw spanning the first and second metatarsals comes in close proximity to the dorsomedial skin surface and appears to have backed out approximately 7 mm best seen on the oblique view

Postoperative changes of prior midfoot arthrodesis. There is peri-metallic lucency about multiple of the screws suggesting mild loosening.
One of the screws has backed out approximately 7 mm and the head is in close proximity to the dorsomedial skin surface.

For ICD-10 what are the dx codes. I have reviewed, but I would like to get others opinions.
Thanks

 

[chembree]

My opinion is...

I would use a complication code if there is a clear cause-and-effect relationship to establish the wound is a result of the pin.

If there is not a direct cause-and-effect relationship stated by the provider I would code the wound as initial because the PT is receiving active treatment.

I would not use a sequela code because this is not condition produced. It is not a result of the fracture, but instead a result of the equipment/pins.

Again, this is just my thoughts... and I am open to others ideas.

 

[mitchellde]

My opinion is...

I would use a complication code if there is a clear cause-and-effect relationship to establish the wound is a result of the pin.

If there is not a direct cause-and-effect relationship stated by the provider I would code the wound as initial because the PT is receiving active treatment.

I would not use a sequela code because this is not condition produced. It is not a result of the fracture, but instead a result of the equipment/pins.

Again, this is just my thoughts... and I am open to others ideas.

I would use the code for mechanical complication of the internal fixation device and since this is the active treatment of the complication I would use an A for initial.