Selection of PDX multiple rib fracture vs pneumothorax

jwright@chmed.org

Question regarding selection of PDX for Hemopneumothorax requiring chest tube  for multiple  (2) rib Fracture. Should rib fracture be PDX or pneumo? Other than pain control nothing was done for the rib fractures. Chest tub was in for 48 hours. Notes state CT did not show any aortic dissection or mediastinal structural injury but it did confirm fractures of 2 ribs on left side accounting for the cause of the pneumothorax.

evanspx@sutterhealth.org

Would a pt ordinarily be admitted for pain control due to rib fractures?  How 'significant' was the hemopneumothorax (how large), and which do you believe may have represented greater risk if not treated as an inpatient?   Based on the limited info provided,  'sounds' like the hemopneumothorax is the chief reason for admission.

Paul Evans, RHIA

morris-jeff@CooperHealth.edu

Paul beat me to it, but sounds like the majority of the resources were aimed at the hemopneumothorax and I'd typically use that as the PDX.

Jeff

Lori.Drodge@mainehealth.org

See the "code first" note under S22 (rib fractures).  S27 (intrathoracic injury) must be coded first when present with S22. 

jwright@chmed.org

Thank you all!