tci ED Coding & Reimbursement Alert - 2009 Issue 1

Reader Questions: ID Key Terms to Nail Down Hematoma Coding

Question: A patient presents to the ED after crushing the tip of his right thumb during a rugby match. Notes indicate that the ED physician used trephination to evacuate a subungual hematoma. I am somewhat new to ED coding, and am having trouble with these encounter notes. How should I code this procedure? Ohio Subscriber Answer: A subungual hematoma occurs when blood (or other purulent fluid) collects between the nailbed and the fingernail. This injury causes painful pressure to build in the affected digit, which the ED physician can relieve through trephination (burring of a small hole into the...

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