07.31.10
Posted in Chest at 1:19 pm by admin
Q: A burn patient arrives in the ED after being involved in a house fire where she was removed from the bedroom engulfed in smoke and unresponsive. The initial evaluation included intubation, a carbon monoxide level and ABG showing pO2 60 mmHg. In addition, a bronchoscopy was done to assess the airways. The results were positive carbonaceous deposits requiring lavage to clear the airway and erythema with friable membranes.
A: 419206.5; The mechanism of injury implies inhalation burn from breathing the superheated air along with the smoke. Inflammation of the airways, friability with obstruction of the bronchi requiring clearance is evidence of severe inhalation injury; ABG demonstrates hypoxemia as well
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07.01.10
Posted in Face at 1:09 am by admin
Q: Your newest trauma patient has suffered a basilar skull fracture. While reading the CT scan of the head, you notice that there is also a dislocation of the ossicles on othe left. After coding the basilar skull fracture correctly, you are left with a decision about the ossicular dislocation. How do you code this specific injury?
A: 240212.1; the ossicles are seen on CT scan but they are the skeletal component of of the ear. Thus, the AIS code for the ossicles is found in the face, under the organ “ear”. This injury is frequently associated with a basilar skull fracture, which would be coded separately. The patient is likely also demonstrating issues with hearing on the left where the ossicles are dislocated.
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