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Family Practice Coding Alert

READER QUESTIONS:

Count a Non-Healing Lesion as Complicated

Question: Should I use 739.0 as the ICD-9 code for a non-healing lesion of the head?


Rhode Island Subscriber
Answer: No. You-re probably incorrectly assigning a code from the -Musculoskeletal System and Connective Tissue- section instead of reporting a code from the -Injury and Poisoning- section.

Chiropractors use nonallopathic lesion codes (739.0-739.9) to identify a subluxation or chiropractic dislocation of the spine. These diagnoses explain the medical necessity for chiropractic manipulative treatment. Example: For a head region subluxation of the spinal code, you would report 98940 (Chiropractic manipulative treatment [CMT]; spinal, one to two regions) with 739.0 (Nonallopathic lesion, not elsewhere classified; head region).

The family physician more likely treated a patient's wound that wasn't healing. You should report a non-healing wound with an open wound code. ICD-9 lists two codes for open wounds of the head. For an open wound of head without mention of complication, assign 873.8 (Other and unspecified open wound of head without mention of complication). Classify a complicated open wound of the head as 873.9 (Other and unspecified open wound of head, complicated).

Final step: Because the FP in your scenario indicates the wound had delayed healing, you should consider the wound complicated and assign 873.9. ICD-9 specifies, -The description -complicated- used in the fourth-digit subdivisions includes those with mention of delayed healing, delayed treatment, foreign body or infection.-

You may want to check with the physician for a specific non-healing reason, which may allow you to select a more specific code than the other and unspecified code 873.9. For instance, if the wound is the result of a non-healing surgical wound, you would assign 998.83 (Other specified complications of procedures, not elsewhere classified; non-healing surgical wound).