NPWT Evidence Library › Coding and funding
Coding and funding (South Africa)
Coding and PMB information is a research aid. Verify it against the current ICD-10 MIT, the scheme's rules and the PMB regulations before submission. A code's presence on the PMB coded list does not by itself make a condition a PMB.
The ICD-10 codes and PMB diagnosis–treatment pairs most often relevant to each wound type. Lead a motivation with the primary diagnosis code.
| Wound type | ICD-10 | PMB |
|---|---|---|
| High-risk closed incisions (ciNPT) | I70.20, E11.5 | via the underlying disease being operated on |
| Contaminated or dehisced surgical wounds | T81.4, T81.3 | via the underlying condition; T81.3 dehiscence is listed under 373J; 904S only if septicaemic (T81.4) |
| Groin wound complications | T81.3, T81.4, I89.8 | 915E via the underlying arterial disease; T81.3 dehiscence is listed under 373J (non-superficial open wound); 900E if the prosthetic graft is involved (T82.7) |
| Sternal wounds | T81.4, T81.3 | via the cardiac-surgery condition; T81.3 is listed under 373J; 904S only if septicaemic (T81.4) |
| Open abdomen | T81.3, K65.9 | via the underlying abdominal emergency |
| Skin grafts and graft-bed preparation | code the wound being grafted; T86.8 only if the graft or flap has failed | via the underlying wound being grafted |
| Diabetic foot wounds | E11.5, E10.5, E14.5, L97 | 915E (diabetic PVD / gangrene); diabetes-with-complications pathway |
| Wounds in peripheral arterial disease | I70.21, I70.20, L97 | 915E (gangrene / severe atherosclerosis / diabetic PVD) |
| Ischaemic or borderline-perfusion wounds | I70.21, I73.9 | 915E (via the underlying arterial disease) |
| Amputation stump wounds | T87.5, T87.4, T87.6 | 915E via the underlying arterial/diabetic disease; 904S only if septicaemic (T87.4, T87.5) |
| Venous leg ulcers | I83.0, I83.2, L97 | venous disease is not PMB-level as such; fund via the underlying condition where one exists and confirm before quoting |
| Pressure injuries | L89.2, L89.3 | no pressure-injury DTP is recorded in this wiki; fund via the underlying condition (spinal cord injury, immobility after PMB-level illness) and confirm before quoting |
| Necrotising infection and Fournier's gangrene | M72.66, N49.8, N76.8, A48.0 | 349J (necrotising fasciitis M72.6x; cellulitis L03.x); 277S for gas gangrene (A48.0) — its treatment component names HBOT |
| Infected wounds needing instillation (NPWTi-d) | T81.4, M72.66 | via the underlying infected condition |
| Infected or exposed vascular grafts | T82.7, I70.21, I73.9 | 900E — life-threatening complications of elective cardiac and major vascular procedures (T82.7 listed); plus 915E via the underlying arterial disease |
| Open fractures | S82.x1, S72.x1 | 900H — open fracture/dislocation of bones and joints (S72.x1, S82.x1 are listed under it); closed fractures map to 902H |
| Burns | T31.x with the site code T20-T25 | 900J — burns >10% of body surface, or >5% involving head, neck, hands or perineum (T20–T25, T31.1–T31.9 listed); smaller burns elsewhere are not PMB-level |