Coding complication from CPR
Patient suffered a spleen lac clearly documented from CPR. The coders code it to "accidental puncture or laceration to the spleen during a procedure on the spleen". This is flagging our PSI 15 measure. Is this the correct way to code a spleen laceration due to CPR?
Comments
I don't think this is correct, though I cannot say I have seen this before. First of all, that code is incorrect, this was not a procedure on the spleen so even if coded as a complication, it should not be that code. That being said, I don't believe it should be coded as a complication. I know its not as black and white as a rib fx, but we do have guidance about rib fx.
ICD-9-CM Coding Clinic, First Quarter 2013 Page: 15 Effective with discharges: March 27, 2013
Question:
What is the diagnosis code assignment for a rib fracture due to cardiopulmonary resuscitation?
Answer:
Assign code 807.00, Fracture of rib(s), sternum, larynx, and trachea, rib(s), closed, rib(s), unspecified, and code E879.8, Other procedures without mention of misadventure at the time of procedure, as the cause of abnormal reaction of patient or of later complication, Other specified procedures. Fractures of the rib occurring secondary to cardiopulmonary resuscitation (CPR) efforts are not uncommon and a known risk; therefore, this would not be classified as a complication. Although the fracture is not considered a complication, the E-code is assigned to provide information about how the fracture occurred.
I would have coded this as S36039A, but, I do not have any specific guidance to support this code assignment. But, if you don't start with 'complication', this is where I would end up.
As a side note- I am assuming this happened after admission? Just making sure your POA indicator is correct here. I have seen issues with similar injuries occurring in the ED being coded as POA-N even though they occurred prior to the order for admission.
Katy Good