Wright Medical Billing, LLC

11/28/2025

A Very Coded Christmas: Home Alone, ICD-10 Edition

It was a snowy Christmas Eve when Kevin McCallister woke up and realized he was home alone. Meanwhile, two burglars, Harry and Marv, plotted their break-in… completely unaware of the ICD-10 codes about to define their holiday.

The First Trap – Ice on the Steps

As Harry stepped onto the icy porch, he slipped and landed flat on his back.

ICD-10-CM code:
W00.0XXA – Fall due to ice and snow, initial encounter
S30.0XXA – Contusion of lower back and pelvis

11/27/2025

The ICD-10 code for contact with an electric knife is W29.1. This code is used to specify the external cause of an injury, and it must be used alongside another code from Chapter 19 (S00-T88) that describes the nature of the condition, such as the resulting injury. You must also add a 7th character to specify the encounter: 'A' for initial encounter, 'D' for subsequent encounter, or 'S' for sequela.
ICD-10 code for contact with electric knife
W29.1XXA: Contact with electric knife, initial encounter
W29.1XXD: Contact with electric knife, subsequent encounter
W29.1XXS: Contact with electric knife, sequela
Important considerations
External cause: W29.1 is an external cause code, not the diagnosis for the injury itself.
Combination: You must use this code with another ICD-10 code that describes the actual injury (e.g., a burn or cut) from Chapter 19, such as the S00-T88 range.
Specific encounter: The 7th character is essential to specify the encounter type.
Intent: Use this code for accidental contact. For intentional acts, such as an assault, a different code (like X99) would be appropriate

S61.211A is the correct ICD-10 code for an initial encounter with a laceration of the left index finger without a foreign body or nail damage. This code is used for the initial treatment of the wound, while other codes like S61.211D (for subsequent encounters) or S61.211S (for sequela) would be used for follow-up visits or long-term effects, respectively.

11/26/2025

ICD-10 code Y93.G3 is used to specify that the external cause of an injury or health condition was the activity of "cooking and baking". This code is part of the "Activity codes" section and is used to provide greater detail about the circumstances leading to a medical event. It includes activities like using a stove, oven, or microwave, as well as other forms of cooking and baking.
Details on Y93.G3
Category: Chapter 20, External causes of morbidity
Specific Code: Y93.G3
Purpose: To identify the activity that caused or contributed to an injury or health condition.
Examples of activities:
Using a stove, oven, or microwave
Food preparation, cooking, and baking
Grilling and smoking food (though there are other sub-codes for these, Y93.G3 can be used)
Applicable injuries: The code can be used for injuries such as burns, cuts, and scalds that happen during these activities.
Usage: It is a billable code used for reimbursement purposes.

The main ICD-10 codes for a burn on a right index finger pulling a turkey from an oven are T23.021A (first-degree burn)

11/24/2025

ICD-10 code W61.43 is the specific code for "Pecked by a turkey". This is a non-billable code used to identify the external cause of an injury. For billing, you must add a seventh character to specify the encounter type: W61.43XA for initial encounter, W61.43XD for subsequent encounter, or W61.43XS for sequela.
How to use the code
W61.43: The base code indicates a turkey peck incident.
W61.43XA: Use for the initial encounter when the patient is first seen for the injury.
W61.43XD: Use for a subsequent encounter for continued care for the same injury.
W61.43XS: Use for a sequela, meaning a long-term condition or complication resulting from the injury.
Important considerations
This code describes the circumstance of the injury, not the nature of the injury itself.
You must use a secondary code from another chapter (most likely Chapter 19, S00-T88) to describe the actual injury, such as a cut or bruise.
The full combination of codes is necessary for proper medical billing and claims.

11/23/2025

The HCPCS EX modifier indicates that a Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) item was purchased for a Medicare expatriate beneficiary while they were present in the U.S. It is a specific modifier used on claim lines by suppliers to identify these items and does not apply to oxygen equipment, parenteral/enteral nutrition, or routinely purchased rentals.
Purpose: To identify DMEPOS items purchased for U.S.-based expatriate beneficiaries.
Application: Must be included on all claim lines for the covered items.
Exclusions: Does not apply to oxygen equipment, parenteral/enteral nutrition, or certain rental items.

11/23/2025

The HCPCS modifier EJ is used for billing the subsequent doses in a defined course of therapy. It is not used for the first dose or injection of a series.
Common applications
The EJ modifier is often used with HCPCS J-codes for injections of drugs that are administered in a series. Examples include:
Hyaluronic acid injections: For the treatment of knee osteoarthritis, Medicare requires the EJ modifier to be applied to the HCPCS code for the drug for each injection after the first one in a series. A new series can be repeated after six months or more have passed since the previous one was completed.
Erythropoietin (EPO): EJ is used for subsequent claims for this drug, which is used to treat anemia.
Infliximab: EJ is applied to subsequent doses in a series of infusions for this drug, which is used for autoimmune diseases.
Coding guidelines
Informational only: For Medicare, the EJ modifier is for informational purposes. It helps explain that the claim is for a follow-up treatment rather than the initial one.
Placement: When billing, you should place the EJ modifier in the last modifier position on the claim form, after any other applicable modifiers.
Documentation: Clear documentation is essential. Medical records should support that the injection is part of a series, defining the specific joint and treatment.
An example for knee injections
A physician provides a patient with a series of five hyaluronic acid injections for knee osteoarthritis.
First injection: Bill the HCPCS code for the drug and injection procedure. Do not use the EJ modifier.
Second, third, fourth, and fifth injections: On all subsequent claims, append the EJ modifier to the HCPCS drug code to indicate that these are subsequent treatments in the defined series.

11/22/2025

The medical coding for functional dyspepsia, also known as indigestion, is ICD-10-CM code K30. This is a billable code used when a patient has long-term indigestion symptoms without a clear physical cause, such as an ulcer or inflammation, identified through tests like endoscopy.
Key facts about ICD-10 code K30
Definition: Functional dyspepsia is a chronic digestive disorder where symptoms persist without a detectable physical cause.
Symptoms: It can include symptoms such as burning stomach pain, bloating, nausea, excessive or early fullness, and belching.
Usage: It is used when the cause of the indigestion is not due to other conditions like gastritis or GERD, which have their own specific codes.
Classification: K30 is part of the ICD-10-CM classification for diseases of the esophagus, stomach, and duodenum.
Other conditions: This code can also be used for conditions that mimic indigestion, such as some forms of GERD (K21) or non-ulcer dyspepsia

11/22/2025

For medical coding purposes, ICD-10 code R63.2 is for polyphagia, or excessive eating. It is classified under "Symptoms and signs concerning food and fluid intake".
Key coding information
Description: Polyphagia is a medical term for excessive or extreme hunger and increased appetite, often leading to overeating.
Code category: It is in Chapter 18 of the ICD-10-CM, which covers "Symptoms, signs, and abnormal clinical and laboratory findings, not elsewhere classified" (R00-R99).
As a symptom code: R63.2 is a symptom code, not a definitive diagnosis. It should be used when the underlying cause of the overeating is unknown. If the cause is identified (e.g., diabetes or an eating disorder), that condition should be coded instead.
Excludes notes: ICD-10 specifies that R63.2 should not be coded with certain other conditions, such as:
Eating disorders (F50.-)
Bulimia nervosa (F50.2)
Code also: Coders should consider coding for associated conditions if applicable, such as genetic susceptibility to obesity (Z15.2) or obesity due to a specific genetic pathway disruption (E88.82).
Example coding scenario
Patient presents with symptoms of polyphagia. The physician has not yet determined the underlying cause, but notes the patient's complaint of excessive, uncontrollable hunger.
Initial visit: For the initial visit, the coder would use R63.2 as the primary diagnosis to report the patient's symptom.
Follow-up visit: After further testing, the physician diagnoses the patient with Type 1 diabetes. In this case, the coder would now use the specific code for Type 1 diabetes and no longer use the symptom code R63.2.

11/14/2025