Injuries and External Causes on Holiday

by Melanie Endicott

A recent study published by the US Consumer Product Safety Commission (CPSC) estimates that more than 15,000 injuries attributable to holiday decorating occurred during November and December 2012. These injuries range from falls to burns to lacerations to back strains. As you prepare for ICD-10-CM/PCS implementation, think about how the increased specificity will better reflect these injury and external cause codes. Below are a few holiday decorating injury scenarios mentioned by the CPSC and their respective ICD-10-CM/PCS codes.

Scenario One

Fall from ladder while putting up Christmas lights at home resulting in fractured left distal tibia; repaired with ORIF

• S82.302A, Unspecified fracture of lower end of left tibia, initial encounter for closed fracture
• W11.XXXA, Fall on and from ladder, initial encounter
• Y92.009, Unspecified place in unspecified non-institutional (private) residence as the place of occurrence of the external cause
• Y93.8, Activity, other specified
• Y99.8, Other external cause status
• 0QSH04Z, Reposition left tibia with internal fixation, open approach

Scenario Two

Third degree burn of the palm of the right hand due to putting out a Christmas tree fire in an apartment; treated with dressings

• T23.351A, Burn of third degree of right palm, initial encounter
• X08.8XXA, Exposure to other specified smoke, fire and flames, initial encounter
• Y92.039, Unspecified place in apartment as the place of occurrence of the external cause
• Y99.8, Other external cause status
• 2W2EX4Z, Dressing of right hand using bandage

Scenario Three

Left foot laceration with retained foreign body caused by stepping on a broken ornament at church; removal of foreign body

• S91.322A, Laceration with foreign body, left foot, initial encounter
• W22.8XXA, Striking against or struck by other objects, initial encounter
• Y92.22, Religious institution as the place of occurrence of the external cause
• Y93.8, Activity, other specified
• Y99.8, Other external cause status
• 0HCNXZZ, Extirpation of matter from left foot skin, external approach

Melanie Endicott, MBA/HCM, RHIA, CDIP, CCS, CCS-P, FAHIMA, is senior director of HIM practice excellence, coding and CDI products development at AHIMA. She has over 15 years experience in HIM and coding, with her most recent focus being in ICD-10-CM/PCS, and has presented numerous times at the regional, state, and national levels on HIM and coding topics. She was previously a director of HIM practice excellence, focusing on coding products, resources, and education, at AHIMA. Melanie is an AHIMA-approved ICD-10-CM/PCS trainer and an ICD-10 Ambassador.