Wiki External Cause codes used for Dermatology

FUTURE09

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Hello,
I'm looking to understand why my new employer listed External Codes (S00.00XA) primary, (Z08) secondary and then (Z85.828), when a patient is coming in with new lesions and also for F/U for personal hx of malignant neoplasm of skin. I'm not understanding why the external code usage? I would only use the Z08/Z85.828 for the E/M charge line.

Thoughts?
Thank you in advance!
 
Without seeing documentation, it's hard to know why they used these, so you'd really have to ask them to explain their rationale. However, I have frequently seen the 'S' injury codes often used inappropriately when a physician documents a post-operative surgical wound or other wound that is due to causes other than injury, so my guess is that this patient is returning for an evaluation of the wound where the physician removed a lesion and the provider or coder incorrectly selected a traumatic wound code for a new injury rather that the codes that would have correctly described the reasons for the encounter.
 
Hello,
I'm looking to understand why my new employer listed External Codes (S00.00XA) primary, (Z08) secondary and then (Z85.828), when a patient is coming in with new lesions and also for F/U for personal hx of malignant neoplasm of skin. I'm not understanding why the external code usage? I would only use the Z08/Z85.828 for the E/M charge line.

Thoughts?
Thank you in advance!

FYI S00.00xa is not an external cause code it is a code for a superficial injury to the scalp
Z08 if follow for a neoplasm
Z85.828 is history of neoplasm of the skin.
So it could be a logical choice if the patient present with a new scalp laceration but not for a lesion on the scalp. and also has a prior history of a skin neoplasm.
S codes are for the injury caused by trauma not the external cause of the injury those all begin with W, X, or Y
If it is a skin lesion on the scalp and not documented as due to trauma then you should probably be looking at a code in the L chapter.
without the chart note it is hard to know the right answer
 
Thank you everyone! I agree, the code being used is from the External causes chapter, I misspoke. I have since spoken with the physician and he states he's only listing because the old billing agency requested him to do so, due to some insurance rejections? I do not feel, in this scenario, that he should be using these external causes codes, unless the patient states they came from tanning beds or excessive hot/cold exposure. If it was just because of our normal day to day sunlight and possibly age, I do not feel I should be listing them.
 
I am having problems understanding your question. Can you provide a sample encounter where an external cause code was used? I agree you don't just add them . the provider must document the cause of a condition in addition to the condition itself. external cause codes may be used in conjunction with any other code from any chapter to explain the reason a condition exisits if it is due to an external cause.
 
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