Title: Module 15 Coding injuries
Course: Introduction to Coding and Classification Systems > Section: Module 15: Coding of Injuries, Burns, Poisonings and Complications of Care

Introduction

Wonderful!! You have survived the cardiovascular and the neoplasms chapters. Only one more module left covering actual coding of diseases and conditions in ICD-10-CM. In this module, you will learn about coding of injuries, burns, poisonings and complications of care. It will cover Chapters 30, 31 and 32. Again, just concentrate on coding the diagnosis here! Complete the even numbered coding questions in each exercise.

The chapter on injuries uses extensive inclusion and exclusion notes which make for some long and complicated codes. Most codes in the coding of injuries have seventh-character extensions that are required for each applicable code (extension A, extension S, and extension D). You will also learn about sequencing of injuring codes, multiple injury codes, external cause of morbidity, late effects of external causes, child and adult abuse codes, fractures, dislocations, blood vessel and nerve injuries, amputations, and trauma.

The selection of external cause of injury codes is guided by the Index to External Cause of injury and the inclusion and exclusion notes in the Tabular List. Reporting external cause of injury codes provides data for injury research and evaluation of injury prevention strategies. Read through the textbook for explanations regarding the types of codes needed to fully describe the situation and circumstances surrounding an injury.

Many fracture codes can be extended out to the seventh-character and vary according to the bones affected and whether it is initial, subsequent or sequela. Refer to code S52 in the Tabular List to see a good example of this. Careful attention should be given to the Tabular list seventh-character extensions for a specific category to accurately code these injuries.

Multiple fractures are sequenced in accordance with the severity of the fracture.

Burns are coded to the anatomical site, depth of the burn and extent of the burn utilizing the Rule of nines. Codes are sequenced according to the severity of the burns, with the highest degree taking precedence. External cause of injury codes are used to classify the place of occurrence and the source of the burn, whether fire, electrical, hot liquid and to also indicate the situation such as accident, assault, or suicide.

Poisonings and adverse effects are covered in Chapter 32 in your textbook. An adverse effect is on caused by a correctly prescribed and used drug. A poisoning is a condition caused by the incorrect use of a drug or another substance. Interactions of properly used drugs and alcohol or nonprescription drugs are considered a poisoning. A condition cause by use of a drug may be coded as either an adverse effect or a poisoning. The key is whether or not the substance was correctly prescribed and properly administered.

Note: An iatrogenic condition is a condition resulting from the treatment of another condition. Example: Treating a patient with chemotherapy for a neoplasm and subsequently the patient has aplastic anemia.

Not all conditions that occur following surgery or other patient care are classified as complications and no time limit is defined for the development of a complication. The coder should follow the Alphabetic Index and instructional notes carefully when selecting a complication code. Read the exclusion notes extensively. Locate the condition first and then search for the subterm indication a postoperative or iatrogenic condition or locate it under the term Complication.

Course Outcomes

- Recognizes the basic coding steps for coding medical diagnosis in both ICD-9-CM and ICD-10-CM. (1)
- Comprehends the basic coding guidelines established by the American Hospital Association for both ICD-9-CM and ICD-10CM. (2)
- Converts medical documentation into both ICD-9-CM and ICD-10-CM codes. (3)

Objectives

After completing Module 15 you should be able to:

- Use External cause codes to assist in the coding of an injury
- Select the correct seventh-character extension
- Code for open wounds and other varieties of injuries.
- Identify types of fractures.
- Know the difference between first-, second-, and third-degree burns.
- Properly sequence the codes of multiple burns and related conditions.
- Understand how the extent of burn is calculated using the "rule of nines."
- Differentiate between adverse effects and poisoning.
- Located codes associated with poisoning and adverse effects.
- Code for poisoning due to substance abuse.
- Code for late effects for adverse reactions and poisonings.
- Know when and when not to cod a condition or occurrence as a complication.
- Code complication codes.
- Use all of the instructional notes present in ICD-10-CM to properly classify a condition caused by a complication of medical or surgical care.

Readings and Resources

- Chapters 30, 31, 32, and 33 and complete even numbered questions in the exercises to prepare for Test 15.
- Review coding guidelines for coding external causes, adverse effects, poisonings, fractures, burns, and complications of surgical of medical care.

Congratulations!! You have successfully completed the coding instruction for this course. Now, you will learn about Present on Admission (POA) reporting requirements next week. This is located in Appendix A of your textbook.

Discussion

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Test
This test has 20 questions worth two points each.You have one hour to complete the open book exam. You have the opportunity to retake the exam if you want to improve your original score.