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Correctly Code Crush Injury of Hand

Posted on 17. Jun, 2011 by in Coding Challenge, Hot Coding Topics

Question:
We have a patient who had a severe crush injury of the left hand which led to a comminuted fracture of the left 3rd and 5th metacarpals with an intra-articular fracture of the proximal phalanx of the left index finger.  The physician’s documentation indicates the following:

  • There was also a soft tissue defect over the left proximal interphalangeal (PIP) joint of the middle finger.  After taking samples for culture, the wounds were meticulously débrided and curetted.
  • Bony structures were evident over the 3rd metacarpal as well as on the PIP of the middle finger where the defect was about 3-1/2 to 2-1/2 inches. The area of the dorsum of the PIP joint of the left middle finger was about ¾ inch x ¾ inch.
  • Debridement and irrigation was done using 6 liters of saline with the gravity Patzakis technique and 1 liter of antibiotic.
  • After the wound was

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