Title: Module 8 Coding External Injuries
Course: Introduction to Coding and Classification Systems > Section: Module 8: Coding External Causes of Injury

Introduction

Hang in there, half way there and this module is the last one for ICD-9-CM! You have survived the pregnancy, cardiovascular, and neoplasm coding chapters, now we will cover Chapters 26, 27, 28, and 29. You will encounter coding External Causes of Injury codes (E Codes) within Chapter 26 to fully describe the conditions and circumstances of injuries. Inclusion and Exclusion notes are used extensively in this chapter to code the case accurately so it is important to pay special attention in your coding manuals to any inclusion and exclusion notes listed under the code categories.

To select E codes, a separate Index to External Causes is provided in Section 3 (last section) of Volume 2 –Alphabetic Index to access these codes.

NOTE: When coding late effects of injuries, the residual condition (such as malunion, nonunion, deformity or paralysis) is sequenced first, followed by a cause of late effects code. A late effect E Code is also assigned.

When coding burns: The coder must know the terminology representing the degrees of burns, extent of the burn, and the sequencing of third, second and first degree to code correctly.

Codes for poisoning and E codes associated with poisonings are easily located in the Table of Drugs and Chemicals in Section 2 of Volume 2 of ICD-9-CM

Guidelines for coding Poisonings and Adverse Effects:

- The condition is classified as an adverse effect when the correct substance was administered as prescribed.
- The condition is classified as a poisoning when the substance was used incorrectly.

Chapter 29 introduces how to code complication of surgery or medical care. Exclusion notes and instructional notes are extensively used and may lead to coding it elsewhere. The term “complication” used in ICD-9-CM does not imply improper or inadequate care. Assigning a complication to care or surgery relies on the documentation within the health record and the provider’s documentation only.

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)
- Applies the official coding guidelines to the coding of medical diagnosis for all body systems (circulatory, respiratory, musculoskeletal, urinary, blood-forming organs, reproductive, gastrointestinal, etc.) (5)
- Demonstrates thorough understanding of selection of the principal diagnosis and any secondary diagnosis associated with the episode of care or hospital admission. (6)
- Performs accurate diagnosis code assignment for all body systems based upon the documentation provided in the health record. (8)

Objectives

After completing Module 8 you should be able to
- Use E codes to assist in the classification of an injury.
- Classify fractures up to the fifth digit.
- Code for open wounds and other varieties of injuries.
- Understand the difference between first-, second-, and third-degree burns.
- Use a fourth digit to indicate the depth of burn.
- Properly sequence the codes of multiple burns and related conditions.
- Understand how the extent of burn is calculated using the “rule of nines.”
- Identify injuries and illnesses that might be coded in association with the burns.
- Differentiate between adverse effects and poisoning.
- Locate codes associated with poisoning and adverse effects.
- Assign codes for external causes of poisoning and adverse effects.
- Code for poisoning due to substance abuse.
- Code for late effects for adverse reactions and poisoning.
- Understand when and when not to code a condition or occurrence as a complication.
- Locate complication codes.
- Use all of the instructional notes present in ICD-9-CM to properly classify a condition caused by a complication of medical or surgical care.

Readings and Resources

- Chapters 26, 27, 28, and 29 and complete all exercises to prepare for Test 8
- Review Coding Guidelines

Discussion

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Test
The above link takes you to the test page. There are 25 questions worth 2 points each. You have one hour to complete the open book exam. You may retake the test once to improve your score, if needed.