bproosow
Guest
We have yet another situation where Coding Clinic, Faye Brown and Coder's Desk Reference haven't been much help. We're trying to decide when an infected traumatic wound stops being a "complicated wound" and becomes "posttraumatic."
Generally, it seems that 958.3 is primarily used for infected burns. ICD-9 guidelines state this very clearly.
However, CDR states that 958.3 excludes infected open wounds that should be coded to complicated open wounds. "The term 'complicated' describes wounds that have delayed healing, foreign body, infection, or wounds with delayed treatment."
Most reference material I have available points to using this code for infected burns. Infected wounds code to the appropriate complicated open wound code. Is this 1984 Coding Clinic not really applicable any more?
I know that if the infection is due to cellulitis, we would code that and not 958.3.
The way I am reading all of this is if a wound is still open, we code for the complicated wound. If the wound has healed but is still infected, we code the posttraumatic infection.
I'd love to hear any thoughts on the matter.
Thanks!
Generally, it seems that 958.3 is primarily used for infected burns. ICD-9 guidelines state this very clearly.
Coding Clinic, November - December 1984 Page: 20
Question:
Please explain when 958.3, Posttraumatic wound infection, NEC, is used.
Answer:
Patient is admitted with a wound that has not been treated and the wound is now infected. Code both the wound and the posttraumatic wound infection. Patient's wound was treated and patient now returns with infection at wound site due to failure to follow instructions on care of wound, failure to keep follow-up appointments, or due to the nature of the wound and the initial treatment, which did not entirely cleanse the wound.
Question:
Please explain when 958.3, Posttraumatic wound infection, NEC, is used.
Answer:
Patient is admitted with a wound that has not been treated and the wound is now infected. Code both the wound and the posttraumatic wound infection. Patient's wound was treated and patient now returns with infection at wound site due to failure to follow instructions on care of wound, failure to keep follow-up appointments, or due to the nature of the wound and the initial treatment, which did not entirely cleanse the wound.
However, CDR states that 958.3 excludes infected open wounds that should be coded to complicated open wounds. "The term 'complicated' describes wounds that have delayed healing, foreign body, infection, or wounds with delayed treatment."
Most reference material I have available points to using this code for infected burns. Infected wounds code to the appropriate complicated open wound code. Is this 1984 Coding Clinic not really applicable any more?
I know that if the infection is due to cellulitis, we would code that and not 958.3.
The way I am reading all of this is if a wound is still open, we code for the complicated wound. If the wound has healed but is still infected, we code the posttraumatic infection.
I'd love to hear any thoughts on the matter.
Thanks!