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E code/no E code for complicated wound not initial visit or late effect

  1. #1
    Default E code/no E code for complicated wound not initial visit or late effect
    Medical Coding Books
    I have a pt that comes into a wound clinic for treatment of a complicated wound. You can't use a late effect E-code with a complicated wound code per coding guidelines since it isn't a late effect and you can't use the acute injury E-codes after the first visit. What do you use? Any help would be greatly appreciated. I have insurance companies wanting an E code but I don't seem to have one to give them.


  2. Smile Ecode
    Hi. I use to process claims and also file claims on provider side. You can use an E code to tell indicate what accident etc as to why they have the wound but that is it. It really does not affect the claim payment if an E code is on the claim or not. Insurance companies are most likely just wanting to know what happened to get the wound so they can see if someone else should be paying for that service. I hope that helps you some.

  3. #3
    Thank you for your help. I believe that is what some people do for insurance purposes. I really was on the fence about it since it was so specific in coding guidelines not to. But our billers do get rejects without it so I think it is a case by case basis depending on insurance carriers. It happens so few and far between for me but of course I had one the other day. Thanks.

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