Tuesday, June 16, 2020

Grandparents’ Goofs

by Dianna Foley, RHIA, CHPS, CCS 

Test your ICD-10-CM coding skills with this Klutz family experience.

During the family’s COVID quarantine, Mr. And Mrs. Klutz kept the children and their grandparents in touch via Look-In.  This enabled Mr. and Mrs. Klutz to check in on their parents and provided an opportunity for all of them to catch up.  In recent visits with both sets of grandparents, the children asked each of them to tell a story about a time when they had an injury.  As it turns out, each grandparent had a story to relate.  Test your ICD-10-CM injury and external cause coding skills by assigning the appropriate codes for the initial injuries sustained and any applicable late effects. 

Grandpa Klutz told about the time he worked on the railroad at the steel mill and got his left foot run over by a train.  He had displaced, closed fractures of the first and second metatarsals.  They healed well, but as a result, he now has a contracture of the second toe which causes him pain.

Grandma Klutz related that she used to work as a waitress at a local restaurant.  One day, she was using the plastic wrap that came in an industrial size package, with a very sharp, serrated edge for cutting to cover a bowl of vegetables she had just cut in preparation for the dinner rush.  As she was pulling off a piece of plastic, her right hand slipped and she cut her palm on the sharp edge.  To this day, she has a keloid scar on the palm of her hand which she showed the children.    

Mrs. Klutz’s father, Mr. Clodhopper, told how as a child he had accidentally been bitten by a rattlesnake on his left thigh.  He was on a hike in the forest with his family and had gone down to a creek where he had not noticed the snake sunning itself on a rocky outcropping.  As he saw a fish and called out to his brother to come and see, he startled the snake, which bite him.  Because it took some time to get out of the woods and to a hospital, the venom caused numbness in his left leg.  Later, this became a lifelong problem, eventually resulting in a shortened left femur and leaving Granddad Clodhopper with a limp.     

Granny Clodhopper was just a toddler when she developed nursemaid’s elbow after her dad had been playing with her in the park, swinging her around by her left wrist.  On occasion, she will have recurrent dislocations of the left elbow as a result of that injury.  

All were glad that the initial injuries weren’t any worse and that the grandparents, although perhaps still with some long-term effects of the injuries, were in all other respects well.  Choruses of “I love you” were exchanged all around with promises to visit again next week for more stories.

Click HERE for the answers.

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