While this may seem to be a rather strange collection, for me it's purely educational. I like to teach from real operative reports, so I collect them and use them in training materials. A couple of weeks ago, I dusted off one of my previous procedure reports in preparation for ICD-10-PCS training. It was for a septoplasty and turbinate reduction after what one of my doctor's not-so-lovingly referred to my as my "100-day cold." When I finally saw a specialist, she determined that I had trouble due to a deviated septum, which was caused by an old fracture - probably during childhood.
When I told my mother that I had a deviated septum, probably due to an old nasal fracture from childhood, she could see where I was going. We both knew how my nose got broken and who did it.
I remember thinking one thing and one thing only: if I holler loud enough, my parents will come down the hall to see what's up and my brother will get in a lot of trouble for decking his little sister in the nose. It didn't work. I had a lot of nosebleeds as a child and my brother had watched my Mom stop the bleeding many times before. Within seconds, he had me lying on the bathroom floor with one of the nosebleed-approved washcloths and he was mopping up the blood, making sure I was pinching the bridge of my nose, and telling me shut up before Mom came down the hall. Duh. That was the point!
The bleeding stopped. Several minutes later, Mom came down the hall, asked what happened, saw that my brother had the situation under control, and returned to the living room. Well, that plan kind of backfired. It seems the fact it actually was an accident and his nurturing nature prevented him from getting in trouble.
At any rate, about 25 years later I found myself sitting in the office of an ENT who wanted to straighten out my septum. And then I realized that there's a code for this after-the-fact injury and I was very excited!
- S02.2xxA, Fracture of nasal bones, initial encounter
- Y93.83, Activity, rough housing and horseplay
- Y92.013, Bedroom of single-family (private) house as the place of occurrence of the external cause
Of note, had my doctor documented in my record at the time of surgery that this was due to an old nasal fracture, I could have used this code:
- S02.2xxS, Fracture of nasal bones, sequela