Question

A patient was treated in the emergency department for a nasal fracture. Bleeding was controlled, a splint applied, and the patient sent home. He returned to the ED several hours later with new bleeding from both nares due to the fracture. The ED provider had to repack the nose and insert new splints to stabilize the fracture. What ICD-10-CM code(s) is/are reported for the second ED visit?

a. R04.0
b. S02.2XXD, T79.2XXD
c. S02.2XXS
d. T79.2XXA, S02.2XXA

Answer 1

The correct ICD-10-CM codes for the second ED visit are S02.2XXA for the nasal fracture initial encounter and T79.2XXA for the post-traumatic wound bleeding initial encounter. Codes S02.2XXS and S02.2XXD are not applicable as 'S' is for sequela and 'D' is for subsequent encounters for routine healing.

Step-by-step explanation:

For the second emergency department visit for new bleeding from both nares due to a nasal fracture, two ICD-10-CM codes should be reported: One for the nasal fracture and one for the complication of the fracture. The correct codes would be: S02.2XXA for the fracture of nasal bones, initial encounter, since this is a new presentation of active bleeding and requires active treatment; and T79.2XXA for the complication of the fracture, which in this case is the post-traumatic wound bleeding, initial encounter.

Code R04.0 for epistaxis would not be reported as the bleeding is due to a known fracture. The other options, S02.2XXS and S02.2XXD, are incorrect because the seventh character 'S' is for sequela (complications or conditions that arise as a direct result of a condition), and 'D' is for subsequent encounters for fractures with routine healing, which do not apply to this case.