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Pediatric Coding Alert

Reader Questions:

Get Specific With E Codes

Published on Sun Aug 22, 2004

Question: When should we use E codes? Do they help us collect reimbursement?

Arizona Subscriber Answer: Although E codes (E800-E999) don't generate revenue, you should report them in addition to the appropriate CPT and ICD-9 codes. This way, you ensure that you provide the most specific information possible regarding the patient's injury.

For instance, if a child falls and fractures a finger, you could report E880.1 (Fall on or from sidewalk curb) to indicate that a fall from a sidewalk curb caused the injury. Use the E code in addition to the codes for the finger fracture treatment (26720, Closed treatment of phalangeal shaft fracture, proximal or middle phalanx, finger or thumb; without manipulation, each) and the primary diagnosis, such as 816.xx (Fracture of one or more phalanges of hand). This is very important because billing and payment may be delayed until the insurer has received answers related to the accident.
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