Fracture question

[Sheri Lynn]

I have a case from Practicode that states I was wrong on a DX. I would like to know if I was actually wrong (and why) or if this was just a case of coder preference.
The documentation states that there is a Torus fracture of distal radius and ulna. I chose code 813.47 Torus fracture of radius and ulna. The program chose 813.44 fracture lower end radius and ulna. I believe that the Torus code was more specific, and therefor the more correct code.
I'm just getting frustrated because there are numerous cases like this in the program, which brings my score down. I have no hope of gaining employment if I do not understand why they chose some of the codes the way they do. Thanks!

 

[Marge Atkinson]

You would need to be specific on how they phrased the question… for example:
Where multiple sites of injury are specified in the titles, the word "with" indicates involvement of both sites, and the word "and" indicates involvement of either or both sites.
If the documentation states that there were fractures of both the radius and the ulna – then you would code 813.44 as that is the more specific code. (meaning a fracture of both bones)
Actually 813.47 is the less specific code, as it indicates involvement of either site or both sites.. ICD10 will make this clearer!

 

[Alicia Scott]

Marge, can you explain the use of (with/and) in these two codes?

 

[Marge Atkinson]

Alicia,

813.44 means involvement of both the radius and the ulna (with)
813.47 means involvment of either the raduis or the ulna, or could be both the radius and the ulna. (and)

Marge Atkinson, BS CPC RMC
Business Manager
Centennial Surgery Center

 

[Alicia Scott]

Thanks Marge. I think this will help lots of people who look at this question on the forum.

Just a note for others (with/and) has different meanings for codes like this throughout ICD-9. Again, like Marge mentioned before. ICD-10-CM takes all the confusion away. Another reason you are going to love it.

If you struggle with this you need to make a note in your ICD-9 manual. This is a classic test question. One word can change everything in coding.

 

[Sheri Lynn]

Thanks for the help! And Alicia, you are right. I am very much looking forward to I-10.