April Showers Mishaps

by Dianna Foley, RHIA, CHPS, CCS, CDIP

Test your ICD-10-CM injury and external cause knowledge by coding the scenarios below.

Spring has arrived and with it comes the familiar saying, “April showers bring May flowers.” For the Klutz family, however, April showers often bring something else entirely—minor injuries and a chance for you to test your coding knowledge once again.

One afternoon, the Klutz children were playing outside after a soaking spring shower. Raymond decided it would be fun to jump across the puddles along the sidewalk. Unfortunately, one of the puddles was wider than expected. His foot slipped on the wet pavement and he fell, striking his right elbow on the sidewalk. While it hurt and quickly bruised, nothing appeared to be broken.

Little Dana was busy wearing her bright yellow rain boots and splashing happily in the puddles in the front yard. During one enthusiastic jump, she slipped in the mud and landed on her bottom. The result was a bruised tailbone and a few muddy tears before her mother helped her back inside.

Meanwhile, Peter was riding his bicycle down the wet driveway, ignoring his mother’s warning about slippery pavement. As he turned toward the street, the bicycle tires slid on the wet surface and he fell off, scraping his left knee.

Janine decided to help bring the family’s recycling bin back up the driveway after the rain stopped. While pushing the heavy bin across the slick concrete, it tipped backward and fell onto her right foot. The foot quickly became swollen and painful, but fortunately the doctor later confirmed it was only bruised.

Egon, determined to prove he could run faster than the rain, dashed across the backyard to grab a soccer ball he had left outside. The grass was still soaked, and he slipped, twisting his left ankle in the process. A quick trip to urgent care confirmed a sprained ankle.

Fortunately for the Klutz family, these April showers only resulted in minor mishaps. Mr. and Mrs. Klutz were content that the puddle-jumping and rainy-day activities didn’t result in much more serious mishaps-at least for now!

Click HERE for the answers.

 

Cerebral Embolic Protection

This month, “In the kNOW” covers the ICD-10-PCS codes that are to be used for cerebral embolic protection.

With the October 1^st 2025 ICD-10-PCS code updates, coding professionals gained a way to capture the use of cerebral embolic protection used in conjunction with procedures such as TAVRs (transcatheter aortic valve replacements). These devices are deployed as guardians of the brain. They trap any debris that becomes dislodged during a procedure, thereby preventing a stroke. 

These devices are routinely used during those types of surgical procedures, but because they were removed once the procedure was completed, they were not coded as devices. You’ll recall that in ICD-10-PCS, the definition of devices is that they remain after the procedure is complete. Previously, in order to capture these devices, a New Technology code was assigned. Now, these codes have been moved into the Medical/Surgical section of ICD-10-PCS by adding a new row to the 5A0 table (Extracorporeal or Systemic Assistance and Performance, Physiological Systems, Assistance) with the Duration character (character 5) providing the option Intraoperative. The Qualifier character (character 7) denotes the specific type of filter used. The options for the filter types are:

• M   Single-capture filter
• N    Dual-capture filter
• P     Single deflection filter
• Q    Extracorporeal Flow Reversal Circuit

The revised ICD-10-PCS table is shown below.

Here are examples of each type of filter:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Flow reversal, seen above, temporarily redirects blood flow away from the brain, sending the blood through a filter, and then back into the body through a lower extremity vein. 

Now you are In the kNOW!!

 

About the Author

Dianna Foley, RHIA, CCS, CDIP, CHPS, has 25 years of HIM experience. She earned her bachelor’s degree from the University of Cincinnati and holds RHIA, CHPS, CDIP, and CCS certifications from AHIMA. Dianna’s an AHIMA-approved ICD-10-CM/PCS trainer, an AHIMA-published author, a participant in AHIMA credential item writing and exam development, and served on the AHIMA Nominating Committee. Dianna has held various HIM positions and is now an independent coding consultant. She previously served as a program director for Medical Coding and HIT. She presents on coding topics at the national, state, and regional levels and serves as OHIMA’s Education Coordinator.