Wednesday, February 16, 2011

ICD-9 Code for 'Easy Bruising'?

If you are wondering which ICD-9 code to use for 'easy bruising', just read on and find out:

Easy bruising is a symptom of another condition rather than a standalone diagnosis. As such, the ICD-9 code depends on whether or not the internist identified a cause. So if a cause is identified, then code for the specific disease. However, if no cause is pinpointed, then code for the symptoms.

For easy bruising with no identifiable cause, use 782.7 (Spontaneous ecchymoses). An individual may be suffering from other diseases that predispose him to develop bruises even with minimal trauma (like a light rap on the hands), which otherwise will not happen to normal people; therefore, resulting in 'easy bruising. For patients suffering from these conditions, bruises seem to spontaneously appear without any identifiable reason.

An ecchymosis is a bruise which is larger than 1 cm. A bruise less than 1 cm however not less than 3 mm is called a purpura. A bruise less than 3 mm is called a petechiae. Code 782.7 also applies to petechia but not purpura, which has several other codes (287.0-287.9) depending on the etiology.

Bruises resulting from trauma can take place owing to a variety of factors including falls, accidents, and post-surgeries. In general, use codes 920-924 (Contusion with Intact Skin Surface) for bruises secondary to trauma. For instance, for a soccer player who was seen by an intern for bruises in the heel, use 924.20 (Contusion of lower limb and of other and unspecified sites; ankle and foot, not including toe[s]; foot [which is inclusive of the heel]). Remember, for a soccer player who was seen by an interim for bruises in the heel, use 924.20 (Contusion of lower limb and of other and unspecified sites; ankle and foot, not including toe[s]; foot [which is inclusive of the heel]). Remember that as per ICD-9 codes, these codes exclude contusions that are incidental to specific categories of injuries such as crushing injury (925- 929.9), dislocation (830.0-839.9), fracture (800.0-829.1), internal injury (860.0-869.1), intracranial injury (850.0-854.1), nerve injury (950.0-957.9), and open wound (870.0-897.7).