Wiki When to use External Cause of Injury codes?

[Mrsrpc]

Are external cause of injury codes required for first encounter for Worker's Comp claims only? Or any type of claim when an initial encounter for an injury takes place? TIA

 

[haraml7]

Are external cause of injury codes required for first encounter for Worker's Comp claims only? Or any type of claim when an initial encounter for an injury takes place? TIA

That would depend on the state this has happened in and that particular Workers comp polices for their claims. For the government and commercial medical insurance companies we are told not to use the external codes as the primary dx codes, but for workers comp claims they have different rules sometimes. I would pull up the workers comp info in your state and see if they have a policy guideline for this scenario to help you bill appropriately.

 

[Mrsrpc]

That would depend on the state this has happened in and that particular Workers comp polices for their claims. For the government and commercial medical insurance companies we are told not to use the external codes as the primary dx codes, but for workers comp claims they have different rules sometimes. I would pull up the workers comp info in your state and see if they have a policy guideline for this scenario to help you bill appropriately.

thank you