Health Information Management

Bundle up

HIM-HIPAA Insider, January 19, 2015

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Oh, the joys of being an 8-year-old with a snow day. Joey spent the weekend playing in his newly built snow fort without a hat, scarf, or pair of sunglasses. Now he’s complaining of hot, tender, itchy areas on his cheeks and forehead. Also, his lips and eyelids are really red.

 
Dr. Frosty examines Joey and diagnoses chilblains and sunburn. That seems like a very odd combination, but is actually not unheard of.
 
Exposed skin can get sunburned even when the temperatures are below freezing. Apparently the sun doesn’t care how warm out it is. Sunlight reflects off the snow and ice and, as everyone who lives in snowy areas knows, it always finds the unprotected spots.
 
Sunburn is pretty easy to code in ICD-10-CM. All we need to know is what degree the sunburn is. That’s it. No location, no laterality, no episode of care.
 
Dr. Frosty documents a first-degree sunburn, so we would report L55.0 (sunburn of first degree).
 
On to those chilblains. Don’t know the difference between chilblains and frostbite? The big difference is whether the tissue freezes. If it does, the patient likely ends up with frostbite. Frostbite can be superficial or with tissue necrosis.
 
Chilblains are the painful inflammation of small blood vessels in your skin that occur when you suddenly warm up after being in cold temperatures.
 
Chilblains usually clear up in one to three weeks, but may reoccur.
 
This is another easy condition to code in ICD-10-CM. We only have one choice: T69.1.
 
Hopefully, Joey has learned his lesson and will now listen to his mom when she tells him to bundle up.
 
This article originally appeared on HCPro’s ICD-10 Trainer blog.



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