Q: (ICD-10 Practice Question) “I am having a little trouble on this practice question, maybe I’m only over thinking. Can you help? Thank you.”

You know what, what an interesting thing is that you usually are over thinking it A 23-year-old male who previously suffered a metacarpal fracture of the left hand, 2nd metacarpal bone, as the result of a gunshot wound develops a non-union of the metacarpal.

ICD 10 Practice Question – Medical Coding Practice Test – Video


A: You know what, I honestly don’t know if I answered this. I don’t think I did. So, let’s talk through it. One of things that is different in ICD-10 than ICD-9 is when a person comes in for a sequela which is a late effect and this person has a late effect, it’s a nonunion of the metacarpal. And the metacarpal bones are in the hand, you have the carpals are the little square bones, and then the long bones in the hands are the metacarpals. Then you have the phalanges, then you have the digits; your phalanges are your fingers. So, the long bones that are between your wrist and that first knuckle in your hand that you can feel in there, those long bones, that’s the metacarpals. So obviously, this guy has an injury; he had a gunshot wound in the hand, and it developed a nonunion (the bones didn’t stay lined up). [Ed. Note: Definition of nonunion: failure of the ends of a fractured bone to unite.]

So, you would be able to code for – there’s literally a code for nonunion. And then, at the end of the code, remember in the previous that we were talking about, the letters at the front, now you have letters at the end that would say whether it was the initial encounter or a subsequent or sequela. An initial encounter, a second visit or subsequent visit, then you had sequela (late effect).

Now, I see that someone asked, would there be an E-code? They’re in ICD-10; there are not E-codes. There are E-codes, but they are not the E-codes as we know them in ICD-9. They actually still have codes like E-codes, but they’re in the Z section. So, to be able to tell that this guy suffered this injury from a gunshot wound, you can use that. Now, in addition, E-codes in ICD-9 are only used the first time that the person is being seen; you wouldn’t use it on a sequela or a subsequent visit. But with ICD-10, you can.

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