Poisoning by drugs -- accidental vs undetermined


Hagerstown, MD
Best answers
Our coding department was instructed by "AHA CODING CLINIC FOR ICD-10-CM & ICD-10-PCS 2Q 2016 VOL 3 #2, pgs 8 & 9": "If the intent is unknown or unspecified, code the intent as accidental intent." Our issue is that the mental health carve out for Maryland Medicaid (Beacon Health) does not pay for "accidental intent" but will reimburse for "undetermined intent". If the medical record does not document intent at all, can undetermined intent be coded (which appears to contradict the AHA Coding Clinic referenced earlier?) If not, why is there an undetermined intent option at all? The root issue really seems to be that the mental health carve out does not accept all the T codes it should; however, in the meantime, we are having to write-off a lot of money due to how "intent" is classified. Your help is appreciated.