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as of Oct. 1 to use ICD 10 CM (causality) codes for all trauma diagnoses

  1. Default as of Oct. 1 to use ICD 10 CM (causality) codes for all trauma diagnoses
    Medical Coding Books
    Hello all,
    I need HELP!! One of my physicians came to me asking about the causality reimbursement. He stated they will be required as of Oct. 1 to use ICD 10 CM (causality) codes for all trauma diagnoses or risk losing reimbursement. Does anyone know what this is about? Thanks in advance

  2. #2
    Default
    I believe he is referring to the external "cause" codes V00-Y99

    For example:

    Patient comes in with a fractured left hip from a fall in the bathroom at the nursing home she is in

    S72.92XA Unspecified fracture of left femur, initial encounter for closed fracture
    W18.30XA Fall on same level, unspecified, initial encounter
    Y92.121 Bathroom in nursing home as the place of occurrence of the external cause

    hope this points you in the right direction

  3. Default Hi Networker
    I'm aware of the use of the "cause" codes and we do use them when provided to use by the physicians.
    So, are you saying, you are aware of the loss of reimbursement if the cause codes aren't used with all trauma diagnoses?

    Thanks for respnding


    Quote Originally Posted by sequester25@gmail.com View Post
    I believe he is referring to the external "cause" codes V00-Y99

    For example:

    Patient comes in with a fractured left hip from a fall in the bathroom at the nursing home she is in

    S72.92XA Unspecified fracture of left femur, initial encounter for closed fracture
    W18.30XA Fall on same level, unspecified, initial encounter
    Y92.121 Bathroom in nursing home as the place of occurrence of the external cause

    hope this points you in the right direction

  4. #4
    Default
    Is that the case now that a trauma code without external causes documented will have cause to be denied or modified on reimbursements?

    Peace
    ?_?
    Most office doctors will dictate the fall part but less often will they include the location and activity.

  5. #5
    Default
    I'm not certain as to a negative impact on not using the cause codes for commercial insurance, but I think it will have a negative impact when reporting to medicare.

    https://www.cms.gov/Medicare/Quality...formation.html

    Maybe this will give you more info on the subject.

    Sorry I couldn't help much and didn't mean to doubt your knowledge of the external cause codes

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