Wiki Evaluation after Auto Accident

[karenwelsh]

We recently had a parent bring their child to be checked out after an auto accident. The chart notes state that the child did not have any complaints and E819.9 icd-9 was charted. The insurance company has denied & our billing company states this code cannot be listed as primary.

Any suggestions as to how to "correct" this claim??

 

[conniewilson]

An E code can never be used as a primary diagnosis. You will need to use V714- (observation following accident) as your primary diagnosis. Your E code would be your secondary diagnosis.

thanks, Connie

 

[jewhipke]

You can also use code V65.5 (Person with feared complaint) and use the E-code as secondary.

 

[karenwelsh]

Thank you both for the information!

 

[eadun2000]

You can also use code V65.5 (Person with feared complaint) and use the E-code as secondary.

In order to code to highest specificity, you would code V71.4 plus your two E codes. You would not code V65.5 in this situation. More often than not, in the ER, the patient is examined with x-rays and sometimes labs, such as blood draws and urine screens looking for blood, as an MVA can cause injury to the bladder with the way seatbelts hit on the lower abdomen.

 

[eadun2000]

We recently had a parent bring their child to be checked out after an auto accident. The chart notes state that the child did not have any complaints and E819.9 icd-9 was charted. The insurance company has denied & our billing company states this code cannot be listed as primary.

Any suggestions as to how to "correct" this claim??

I know the Ecode has already been discussed, but would like to point out to you that the patient's private insurance will not pay for this visit. It would fall under the auto insurance of either the driver of that vehicle or the other vehicle, depending on who was at fault.