Pediatric Coding Alert

Diagnosis Coding:

Use E Codes to Establish Medical Necessity, Fully Document Accidents and Injuries

Tip: Never list E codes as primary diagnoses. Accidents do happen--and when it comes to treating pediatric patients, they happen frequently. Round out your diagnosis coding for accidental injuries by adding 'E codes' to your ICD-9 roster, and you can speed up your claims processing. When reporting accidental injuries, poisonings and late affects of injuries, you should remember to use the supplemental E codes listed in ICD-9-CM, when appropriate, to fully document the medical justification for the visit. E codes are not required, and are never listed as the primary diagnosis, because they only identify the circumstances of an accidental injury. However, you may use the E code, and often more than one E code, to fully describe circumstances or establish medical necessity. Example: A child falls from a playground jungle gym and presents to the office complaining of pain in her lower left arm. You evaluate the child and [...]
You’ve reached your limit of free articles. Already a subscriber? Log in.
Not a subscriber? Subscribe today to continue reading this article. Plus, you’ll get:
  • Simple explanations of current healthcare regulations and payer programs
  • Real-world reporting scenarios solved by our expert coders
  • Industry news, such as MAC and RAC activities, the OIG Work Plan, and CERT reports
  • Instant access to every article ever published in your eNewsletter
  • 6 annual AAPC-approved CEUs*
  • The latest updates for CPT®, ICD-10-CM, HCPCS Level II, NCCI edits, modifiers, compliance, technology, practice management, and more
*CEUs available with select eNewsletters.