Coding Rules Current as at 18-Oct-2016 08: 31

Published 15 June 2015,
for implementation 01 July 2015.

Ref No: Q2870 | Published On: 15-Jun-2015 | Status: Current

SUBJECT: Cellulitis with recent injury

Q:

The following scenarios are examples that relate to patients who are admitted with a diagnosis of cellulitis secondary to a recent injury:

1. 
   Small punctuate like ulcer on dorsum just proximal to IP joint with surrounding erythema. Patient had cut left thumb on nail clippers one week ago.
   

1. 
   Knee hot to touch with pus like exudate from a superficial graze. Patient had fallen two days ago. 
   

1. 
   Finger swollen and red post removal of a splinter six days ago. Wound cleaned with saline, aspirated with fine needle, small incision made with scalpel, 1ml pus drained and given IV flucloxacillin. 
   

1. 
   Swelling and tenderness of foot at laceration site the day after the sutures were removed.
   

1. 
   Finger cellulitis with ulceration at site of a burn a week previously.
   

What codes should be assigned for these scenarios?

A:

Cellulitis is a spreading infection of the dermis and subcutaneous tissues caused by certain types of bacteria entering the skin, and may result from insect bites, blistering, penetrating foreign bodies, burns, cuts etc. When coding cellulitis associated with a recent injury, apply the principles in ACS 0001 Principal diagnosis and ACS 0002 Additional diagnoses to determine code assignment and sequence.

Where cellulitis is chiefly responsible for occasioning the episode of care, it should be sequenced as the principal diagnosis. Assign other codes as appropriate following the guidelines in ACS 1911 Burns, ACS 1916 Superficial injuries, ACS 1917 Open wounds and instructional notes in the Tabular List as appropriate. The principles of ACS 0001 and ACS 0002 must be applied on their merits.