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AHA Coding Clinic® for ICD-10-CM and ICD-10-PCS - 2016 Issue 3; Ask the Editor

Traumatic Amputation of Fingers with Further Revision Amputation

This patient had a complete traumatic amputation of the fingers and thumb on his left hand. The left index and middle fingers were reattached. The left thumb, ring and small fingers were not able to be reattached, so a revision of the amputation site was performed. The surgeon documented that “Fish-mouth type amputation” was created and that “bone of the distal phalanx was resected” and “bony prominences were sharply resected with nice revision amputation created on the thumb.” Flaps were also used to close the sites. Is the removal of this additional bone considered a further amputation and coded to the root operation “detachment?” Also, is the flap repair a “transfer?” It appears that the flaps were used to “repair” the amputation site. ...

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