Q: (ICD-10 Practice Question) “I am having
a little trouble on this practice question, maybe I’m only over thinking. Can you help?
Thank you.” You know what, what an interesting thing is
that you usually are over thinking it A 23-year-old male who previously suffered a metacarpal
fracture of the left hand, 2nd metacarpal bone, as the result of a gunshot wound develops
a non-union of the metacarpal. A: You know what, I honestly don’t know
if I answered this. I don’t think I did. So, let’s talk through it. One of things
that is different in ICD-10 than ICD-9 is when a person comes in for a sequela which
is a late effect and this person has a late effect, it’s a nonunion of the metacarpal.
And the metacarpal bones are in the hand, you have the carpals are the little square
bones, and then the long bones in the hands are the metacarpals. Then you have the phalanges,
then you have the digits; your phalanges are your fingers. So, the long bones that are
between your wrist and that first knuckle in
your hand that you can feel in there, those long bones, that’s the metacarpals. So obviously,
this guy has an injury; he had a gunshot wound in the hand, and it developed a nonunion (the
bones didn’t stay lined up). [Ed. Note: Definition of nonunion: failure of the ends
of a fractured bone to unite.] So, you would be able to code for – there’s
literally a code for nonunion. And then, at the end of the code, remember in the previous
that we were talking about, the letters at the front, now you have letters at the end
that would say whether it was the initial encounter or a subsequent or sequela. An initial
encounter, a second visit or subsequent visit, then you had sequela (late effect).
Now, I see that someone asked, would there be an E-code? They’re in ICD-10; there are
not E-codes. There are E-codes, but they are not the E-codes as we know them in ICD-9.
They actually still have codes like E-codes, but they’re in the Z section. So, to be
able to tell that this guy suffered this injury from a gunshot wound, you can use that. Now,
in addition, E-codes in ICD-9 are only used the first time that the person is being seen;
you wouldn’t use it on a sequela or a subsequent visit. But with ICD-10, you can.