Q: Contusion and Abrasion — “Is the code rule for contusion and abrasion the same as ICD-9 was, i.e., code contusion only or do we code both now?”

Chandra: A: The answer to that question is they’re both considered superficial injuries and they would be coded separately. If they’re in the same location, the same body area, the same spot, the patient has both the contusion and abrasion, I typically would not assign a code for both of them. I would go with the more severe, talking to the physician as to what it was, because remember a contusion is bruise, under the skin, and abrasion actually scrapes the skin. Abrasion is actually usually considered a little bit more severe; but you need to work with your providers and find out what their take on it is because they don’t always see eye-to-eye with us, even eye-to-eye with one another. But develop your policy, most coders don’t code for both, but you can. There’s nothing that says you can’t.

VIDEO: Code Rule for Contusion and Abrasion

Alicia: Remember we code for statistical purposes, that’s our primary role, it just happens to be a convenient way to get paid. Whether you code for abrasion or contusion, it’s not going to change the way they get paid. You’re substantiating the CPT code in this scenario. Again, I always think of a person that’s been in a motorcycle accident and they’re always breaking down all of the injuries that are usually all… you got plenty contusion, abrasions, then you have avulsions and everything.

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About the Author:

Alicia has been working in the medical field for over 20 years. She first learned about medical coding while working in a medical records department at a resort town hospital near where she was raised. Through the years she has held several jobs in the medical field from, CNA, EMT, Pharmacy technician and Medial Records Abstractor and Analyst. Outside of the medical field she has worked as a Real Estate agent, and owned her own on-line retail business. The medical field has always been where she felt the most comfortable. Alicia has taught medical coding, billing and medical law and ethics at a private college. She also did contract work in HCC Risk Adjustment and discovered she really enjoyed ICD work. Because she loves to learn Alicia is working towards her Masters in Health Care Administration with an emphasis on education. Having taken many online classes through the years to complete her degree she feels very comfortable with both face to face and on-line learning. Alicia will tell you that not only does she love medical coding but she has a passion for teaching it. Alicia lives in the middle of Texas with her husband who is a Pastor, five of her six children, three dogs and two cats.

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