Epistaxis vs Nasal Fracture
Patient fell face first onto floor and fractured her nasal bones bilat and had an additional fracture through the anterior osseous nasal septum, She had epistaxis. Localized pressure did not stop the bleeding, therefore she required bilat nasal tamponade with balloons. It was documented that she was admitted to monitor airway due to the bilat balloons. The discharge summary lists both the fracture and the epistaxis in list of diagnoses and states: "The patient was monitored over the next 2 evenings due to her trauma as well as bilateral nasal packing. The patient did well without any evidence of respiratory issues."
Our coder wants to sequence the fracture of the nasal bones as PDx because 'they usually don't code the bleeding at a fracture site". Thoughts?