Wiki E Codes

Jacoder

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Hi Everybody,

I have a problem concerning E codes. When a pt goes to a physicians office complaining of something that involves an external cause, the physician uses the correct E code when he bills for this first visit. If that pt comes to the hospital for an x-ray, is this still considered initial care or subsiquent? And can I use the same E codes? I'm just afraid the insurance will kick it out because it might look like the accident happened twice.

Here's another problem: when there is no documentation of an accident (e.i. the patient has a fractured hand but does not recall any injury) is there a certain way you bill it so that the insurance will not reject it for the missing E code? Thanks for your help!

Jennifer
 
In reading the coding guidelines for E codes it states that

"External cause of injury codes (E-codes) may be assigned while the acute fracture codes are still applicalbe. See Section I.C.17.b.1 for coding of acute fractures."

Now, my interpretation of the paragraph preceding this which states you use the E-code for the initial encounter, is that an encounter would include the visit with the doctor and any testing/other services as a result of that visit. I don't take that to be a race to see who gets their bill in first.

E-codes are used for reporting so if only the E/M gets the E-code there would be no way they could track the treatment of this injury. You would get a much more complete picture if the E/M, any labs, any X-rays, or other services be it consults or surgeries all had the E-code attached.

Maybe I'm wrong but this is what makes sense to me.

Laura, CPC, CEMC
 
Thanks for the replies!

Laura, that does make more sense to think of it as a tracking code.

Mangolia1, I was always under the impression that if there was no documentation of an injury then I couldn't use the E928.9. Maybe I should rethink this.

Thanks for your help!:)
 
For unspecified injury in fracture cases E887 can be used as the cause of injury
 
PER provider

ICD-9 guidelines state "Assign the appropriate E code for the initial encounter of an injury, poisoning, or adverse effect of drugs, NOT FOR SUBSEQUENT TREATMENT."

Yes, that is correct ... but each provider has his/her own initial encounter.
So it would be appropriate for the physician in the office, the E/R physician, the hospital, and the radiologist who reads the x-ray to each use the E-code.

Just my opinion

F Tessa Bartels, CPC, CEMC
 
How do you post a new question?

I have been on this website for 40 minutes, unable to find HOW to post a question?! Try FAQ's, it tells you how to set up a poll, all sorts of things, but I cannot find how to post a question. can someone please instruct me?
Thank you!!!
 
Renakirk,

At the bottom of the page here you see all the post titles there is a blue button that says, "New Thread". If you are signed in you should be able to click that button and start typing. Hope this helps!

Jennifer
 
Starting a new thread

I have been on this website for 40 minutes, unable to find HOW to post a question?! Try FAQ's, it tells you how to set up a poll, all sorts of things, but I cannot find how to post a question. can someone please instruct me?
Thank you!!!

Rena ...
Go to the forum you want to post in ... for example DIAGNOSIS ... and right at the top left you'll see a blue button marked "new thread"
Click that button and start typing.

F Tessa Bartels, CPC, CEMC
 
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