Wiki E-codes on CMS 1500

[sparkles1077]

Hello fellow coding professionals,

I have heard that e-codes should not be used on CMS 1500. However, I thought they were required according to ICD9 guidelines. Can anyone confirm that e-codes do not need to be used on the professional bill? Is there a reference?

Thank you
Sparkles

 

[mitchellde]

I am not sure where you heard this but you do use E codes on a 1500 or electronic equivalent for a professional claim. They just cannot be first listed codes

 

[MorganMills]

I agree with True Blue. We use them quite frequently in our office, they just can't be first listed.

 

[soprano]

E codes are not mandatory, although highly encouraged. The exception to this is E codes for adverse effects of drugs. When coding for adverse effect of therapeutic drugs, E codes are required and must be reported. Per ICD-9-CM guidelines, E codes are "intended to provide data for injury research and evaluation of injury prevention strategies."

In the coding guidlines it also states, "These guidelines are provided for those who are currently collecting E codes in that there will be a standardization in the process. If your institution plans to begin collecting E codes, these guidelines are to be applied..."

With that being said, many third party carriers require reporting of E codes for specific patient encounters (e.g trauma.) E code reporting can also be mandatory by state regulations. You will need to know if your state and/or insurance carrier requires reporting of E codes.

I hope this provides some clarification...