# E/M coding an MVA



## littlec1963 (Jun 20, 2013)

Hello,

I code E/M visits inpatient.
If a patient is admitted for an MVA and my Doc visits every day for a week, do I use the MVA E codes for each daily charge? He turns in one charge sheet for the week. If the patient then goes in to acute long term care for more than a month, do I continue to use the original MVA E codes for each charge? A late effect code? doesn't seem to fit since they are still being treated for the original and ongoing injuries. Or just code the injuries without either an E code or a late effect?

Thank You for any help!
C


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## renie (Jun 20, 2013)

I code for the ER facility side.  We use the E codes on the original visit only.  If the patient is admitted it is used on the original admission and then if patient is back again it isn't added.  I agree that Late effect codes would seem inappropriate.  Sorry I can't be more help as I strictly code for the facility.


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## mitchellde (Jun 21, 2013)

for now  for ICD-9 we use the E codes only for the initial encounter, however for ICD-10 CM the system is set up that the external cause codes (V, W, X, Y) codes will be used for every encounter.


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## RFoster1 (Jun 21, 2013)

This is a question I have had as well.  If you see a patient with an 8 or 9 dx code, I've always been taught to include the E code.  However, I've also read that the E code only needs to be used for the initial visit.  If anyone can provide a link to information stating which way it should be, please share.  

TIA!


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## mitchellde (Jun 21, 2013)

After initial treatment for the injury then you should not be using the injury code anymore either, so it goes hand in hand, for ICD-9.  Once the injury has been treated then you should use other codes for the aftercare encounters, such as V codes for follow up or complication codes if that is the case.  So if you use an injury code you need an E code.  Both coded at the initial treatment encounter.  So I guess my question is when are you using injury codes when it is not the initial treatment.


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## RFoster1 (Jun 21, 2013)

For example, pt comes in with a skull fracture from an injury and requires surgery.  The fracture code is used during the initial encounter as well as the surgery and is a 8XX.XX code.


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## mitchellde (Jun 21, 2013)

how long after the initial injury is the treatment?


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## RFoster1 (Jun 21, 2013)

Usually immediately - that day or the following day.


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## mitchellde (Jun 21, 2013)

thn you still use the E code as well since it is still considered the initial treatment.


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## RFoster1 (Jun 21, 2013)

Ok, thank you for your help.


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