AHA Coding Clinic® for ICD-10-CM and ICD-10-PCS - 2023 Issue 3; Ask the Editor

Blast Injury due to Firearm Assault

A patient presented to the emergency department with a gunshot wound to the abdomen with extensive internal injuries following a firearm assault. During surgical exploration, the provider noted a bullet hole in the mid-jejunum with significant “blast” injury, requiring removal of a segment of the small bowel. The surgeon documented, “Massive injury/blast injury to the cecum and right colon, requiring right hemicolectomy.” Depending on whether the wound is described as a blast injury or a gunshot wound, coding professionals may arrive at different codes. How should gunshot wounds (GSW) described as blast injuries of the jejunum, cecum and right colon be coded? When blast injuries are documented, how will one distinguish between primary and secondary? ...

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