Acquired Absence of Right Upper Limb Below Elbow (ICD Z89.211)

Name of the Condition

• Common name: Amputation of right arm below elbow
• Medical term: Acquired absence of right upper limb below elbow

Summary

This condition refers to the loss of the lower portion of a person's right arm, specifically below the elbow. This may be due to surgical amputation or traumatic injury, resulting in the permanent absence of this portion of the limb.

Causes

The absence of the right upper limb below the elbow can be caused by:

• Trauma: Resulting from accidents or severe injuries.
• Medical Necessity: Conditions such as severe infections, tumors, or uncontrollable infections leading to amputation.
• Vascular Diseases: Such as severe peripheral artery disease or diabetes complications.

Risk Factors

• Occupational Hazards: Jobs with higher risk of accidents involving machinery.
• Engagement in High-risk Activities: Sports or recreational activities with a risk of severe injury.
• Medical Conditions: Such as diabetes, which may necessitate amputation due to complications.

Symptoms

• Physical Absence: Visible absence of the right forearm and hand.
• Phantom Limb Sensation: The feeling that the missing limb is still attached.

Diagnosis

The diagnosis is primarily based on:

• Physical Examination: To assess the extent of limb loss.
• Patient History: Review of trauma or medical history that led to amputation.

Treatment Options

• Prosthetics: Fitting of a prosthetic limb to aid functionality.
• Physical Therapy: To aid in adaptation to the absence and improve mobility.
• Occupational Therapy: To assist in managing daily tasks using adaptive techniques.

Prognosis and Follow-Up

• Prognosis: With appropriate treatment, including rehabilitation and prosthetics, individuals can lead active lives.
• Follow-Up: Regular check-ups to monitor stump health and prosthetic fit will be necessary.

Complications

• Stump Complications: Infection, pain, or skin issues at the amputation site.
• Phantom Limb Pain: Persistent discomfort in the area of the removed limb.
• Limited Mobility and Functionality: Challenges in performing daily activities.

Lifestyle & Prevention

• Safety Measures: Adhering to safety protocols to prevent traumatic injuries.
• Health Management: Managing conditions such as diabetes to prevent complications leading to amputation.

When to Seek Professional Help

• Persistent Pain: Unmanageable pain at the site or phantom limb pain.
• Stump Issues: Redness, swelling, or infection.
• Prosthetic Problems: Issues with comfort or usability of prosthetics.

Additional Resources

• Amputee Coalition: Offers support and education for those living with limb loss.
• Mayo Clinic: Provides comprehensive information on limb amputation.
• Prosthetics and Orthotics Associations: Guidance and support for accessing and using prosthetics.

Tips for Medical Coders

• Accuracy: Ensure the correct limb and level of amputation are indicated (right upper limb, below elbow).
• Contextual Information: Include any related conditions, such as the cause, in the patient's medical record.
• Avoid common coding errors such as mixing up side-specific codes (right vs. left).