Coding Injuries in ICD-10-CM -Part 1

        ICD-10-CM offers greater specificity in coding lesions than ICD-9-CM. Although many guidelines for the coding of injuries remain the same as those in ICD-9-CM, the ICD-10-CM includes some new features, such as the seventh character extensions.

In ICD-10-CM, injuries are grouped by body part rather than by category, so that all injuries at a specific site (such as head and neck) are grouped together rather than groupings of all fractures. or all open wounds. Categories grouped by ICD-9-CM lesions such as fractures (800-829), dislocations (830-839) and sprains and strains (840-848) are grouped by site according to ICD-10- CM, such as head injuries (S00-S09), neck injuries (S10-S19) and chest injuries (S20-S29).Know more at Medical Coding Training.

Injury extensions:

Most of the categories in Chapter 19 have seventh character extensions that are required for each applicable code, and most categories have three extensions (with the exception of fractures):

• An initial meeting

• D, later meeting

• S, Sequela

Extensions for initial encounters are used while the patient is receiving active treatment for the injury (for example, surgical treatment, meeting with an emergency department, and evaluation and treatment by a new physician). The extensions for the following meetings are used for meetings after the patient has received active treatment of the injury and receives routine care for the injury during the healing or recovery phase (eg, casting change or withdrawal, removal of external fixation device, adjustment, other follow-up care and follow-up visits following treatment of injuries).

Extension S, sequelae, is used for complications or conditions that arise directly from an injury, such as scarring after a burn. Scars are a sequel to the burn. When using the S extension, it is necessary to use both the wound code that precipitated the sequel and the sequel code itself. S is added only to the injury code, not to the sequential code.

The extension S identifies the injury responsible for the sequelae. The specific type of sequel (eg scar) is sequenced first, followed by the lesion code. Sequela is the new terminology of ICD-10-CM for the late effects of ICD-9-CM and the use of sequential extension replaces the ICD-9- late effects categories (905-909).Get more info on Medical Coding Training.