tci ED Coding & Reimbursement Alert - 2015 Issue 4

You Be the Coder: Is It Really A Complex Repair? Check the Note to Verify it Matches the Physicians' Description of the Wound.

Question: There is no doubt about the significant injury to the toe in this scenario but what is the correct code to capture the laceration repair? Texas Subscriber Chief Complaint: Toe Injury HPI: A 61 year-old female presented to the ED at 12:25 by ambulance. She was triaged at 134:28 with the following vital signs. T: 98.5, P: 86 regular, R 20 unlabored, BP: 212/97, SPO2: 95, AMT: RA, pain 7 of 10 in multiple areas. The patient's primary care physician is unknown. Onset of symptoms was sudden and immediately prior to arrival. Pain continues and is of...

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