Learn all about injury codes, E-codes, and how to use them...
As a medical coder, it's important to know the best coding practices, especially in the case of coding injuries and E-codes.
Even though these codes aren't always required by insurance, they're an important method of adding additional information to a medical claim. A good way to think of it is that every time you use an ICD-9 diagnosis code that's in the 800s or 900s, you also need to include at least one E-code on the claim.
Injury codes are typically any codes that are in the 800s to 900s in the ICD-9 manual. These codes reflect diagnoses or conditions that resulted from some sort of injury, such as a fracture, wound, or bruise.
On the other hand, E-codes are used to give more information about the patient's diagnosis code.
They are most typically used to give more information about a patient's injury, but you can also use them to report more information about any type of diagnosis.
The description of E-codes in the ICD-9 manual is:
Supplemental Classification of External Causes of Injury and Poisoning.
In other words, use E-codes for adding supplemental information to your claims. Insurance companies and other health agencies then use this information to research and evaluate methods of preventing injuries.
There a few different types of E-codes. Each describes certain aspects of the patient's injury, including:
You can include more than one type of E-code on a claim to describe each and every necessary aspect of an individual's injury.
To help you find the correct code more easily, E-codes are divided into specific categories, which group injuries by type:
There are many specific guidelines which govern the way E-codes are reported and used on medical claims.
There are more very specific guidelines than can be listed here. Generally they follow the type of medical coding guidelines as many other diagnosis codes, such as specificity and the correct selection of the first-listed diagnosis.
These guidelines include:
The above list is only a very small portion of the actual E-coding guidelines. There are more guidelines, which govern:
But it's important to keep in mind that you don't have to remember all of this!
When you're actually coding for a doctor's office or medical facility, you'll have your trusty ICD-9 manual in front of you at all times. You'll have all the necessary guidelines in front of you.
Some states make E-code reporting mandatory, so you need to know what you are required to do legally before deciding on whether or not to include E-codes on your claims.
In states where E-coding isn't mandatory, it's up to the doctor's office or facility whether or not include them. It's also important to remember, whether or not your office decides to report E-codes, that they do communicate important information about accidents and injuries.
The Occupational Safety and Health Administration (OSHA) and Worker's Compensation are two agencies that track the reporting of E-codes to keep an eye on the types of accidents that are occurring and the treatments that were provided.
Whether or not it's legally mandated, it's always a good idea to include E-codes on accident claims. These are claims that have resulted from sort of workplace, auto, or other accident that may be covered by an insurance other than medical insurance.
Example: when completing an auto accident claim, you'll need to indicate on the claim status that the visit was due to a car accident. You'll also have to include the date of the accident and all the necessary procedures and diagnoses from the patient's visit.
On this claim, you also need to designate the type of accident (car, motorcycle, pedestrian, driver, passenger, etc). This extra information is given to the car insurance company who'll make a determination, based on the medical claim, whether or not to pay for additional injury fees.
Including E-codes on your claims is good medical coding practice. Correctly finding, sequencing, and reporting E-codes on your claims indicates your commitment to correct coding as well as your professional ability to be a great coder.
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