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Sports InjuriesThe chance for sports injury is enormous, especially among youth and kids. With more number of sports injuries attended by Emergency Departments (EDs), accurate emergency room medical billing and coding is becoming crucial. According to a recent report from the Indiana University School of Medicine, the number of U.S. kids aged five to 18 years old visiting the emergency department for sports injuries increased yearly between 2001 and 2013.

Most of the injuries reported were related to 21 sports, including football, basketball, soccer, baseball, softball and ice hockey. However, the data does not clearly indicate whether the injuries actually became more common in youth sports, or if more kids were participating in sports over time and the injury rate did not change.

Data from the U.S. Consumer Product Safety Commission’s National Electronic Injury Surveillance System of 100 hospital emergency departments were used for the analysis.

Key Findings

Focusing on patients between the ages of five and 18 years presenting at the emergency room for injuries, it was found that:

  • An estimated number of 485,514 injuries were reported during the study period, which got translated to about 16,000,000 sports-related injuries among kids presenting to all EDs nationally.
  • While 74.7 percent of all injuries were related to football, soccer, baseball and basketball, less than 1 percent of reported injuries were connected to golf, martial arts and ice hockey.
  • One third of reported injuries were strains or sprains, and fractures or contusions.
  • Internal organ injury increased from 2.5 percent of the total to almost six percent by 2013. More than 9 percent of all internal injuries came from hockey and more than 8 percent each from rugby and golf.
  • Concussion diagnoses also increased from 2 percent to 4.6 percent of injuries. 6 percent to 9.5 percent each of concussion were caused by ice hockey, rugby and lacrosse.

Treating patients is of course the primary objective of any physician, but it is important to focus on reimbursement as well for which accurate medical billing and coding is vital. Choosing the right ICD-10 codes that have greater specificity than the ICD-9 codes is a time-consuming task. Outsourcing emergency room medical billing tasks is a practical solution taking into account the busy schedule of ER physicians. Submission of error-free medical claims is the key factor for on-time reimbursement.

For coding injuries, three extensions are available – A, initial encounter is used while the patient is receiving active treatment for the injury; D – Subsequent encounter indicates that the patient is receiving routine care for the injury during the healing or recovery phase and S – Sequela indicates that the injury has caused another condition for which the patient is seeking treatment. Injury site, cause of injury and place of occurrence should also be included in the documentation.

For instance, consider these ICD-10 codes for an injury that was sustained on a playground.

  • 812A – Strain of other muscle(s) and tendon(s) at lower leg level, left leg, initial encounter
  • 921D – Laceration of unspecified muscle(s) and tendon(s) at lower leg level, right leg, subsequent encounter
  • 8XXA – Fall on or from other playground equipment, initial encounter
  • 1XXD – Fall from playground swing, subsequent encounter
  • 310 – Basketball court as the place of occurrence of the external cause
  • 318 – Other athletic court as the place of occurrence of the external cause
  • 6A – Activity, physical games generally associated with school recess, summer camp and children
  • 5 – Activities involving other sports and athletics played individually

According to the lead author of the study, “Parents and coaches should seek out good sports medicine doctors to educate families, coaches, and athletes as to safe playing conditions and safe sports techniques. The best treatment of injury is preventing the injury in the first place.”