# E Codes



## Jacoder (Oct 15, 2009)

Hi Everybody,

I have a problem concerning E codes. When a pt goes to a physicians office complaining of something that involves an external cause, the physician uses the correct E code when he bills for this first visit. If that pt comes to the hospital for an x-ray, is this still considered initial care or subsiquent? And can I use the same E codes? I'm just afraid the insurance will kick it out because it might look like the accident happened twice.

Here's another problem: when there is no documentation of an accident (e.i. the patient has a fractured hand but does not recall any injury) is there a certain way you bill it so that the insurance will not reject it for the missing E code? Thanks for your help!

Jennifer


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## Jacoder (Oct 16, 2009)

*. . .*

Any input is appreciated. Thanks!


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## LLovett (Oct 19, 2009)

In reading the coding guidelines for E codes it states that 

"External cause of injury codes (E-codes) may be assigned while the acute fracture codes are still applicalbe. _See Section I.C.17.b.1 for coding of acute fractures_."

Now, my interpretation of the paragraph preceding this which states you use the E-code for the initial encounter, is that an encounter would include the visit with the doctor and any testing/other services as a result of that visit. I don't take that to be a race to see who gets their bill in first.

E-codes are used for reporting so if only the E/M gets the E-code there would be no way they could track the treatment of this injury. You would get a much more complete picture if the E/M, any labs, any X-rays, or other services be it consults or surgeries all had the E-code attached.

Maybe I'm wrong but this is what makes sense to me.

Laura, CPC, CEMC


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## magnolia1 (Oct 19, 2009)

Jennifer....

Regarding the second part of your original post,
you could use E928.9
                   E849.9


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## Jacoder (Oct 19, 2009)

Thanks for the replies!

Laura, that does make more sense to think of it as a tracking code.

Mangolia1, I was always under the impression that if there was no documentation of an injury then I couldn't use the E928.9. Maybe I should rethink this.

Thanks for your help!


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## ahmed (Oct 26, 2009)

For unspecified injury in fracture cases E887 can be used as the cause of injury


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## FTessaBartels (Oct 26, 2009)

*PER provider*



mdunn said:


> ICD-9 guidelines state "Assign the appropriate E code for the initial encounter of an injury, poisoning, or adverse effect of drugs, NOT FOR SUBSEQUENT TREATMENT."



Yes, that is correct ... but each provider has his/her own initial encounter.
So it would be appropriate for the physician in the office, the E/R physician, the hospital, and the radiologist who reads the x-ray to each use the E-code.

Just my opinion

F Tessa Bartels, CPC, CEMC


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## Jacoder (Oct 26, 2009)

Thanks Tessa!


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## renakirk (Oct 26, 2009)

*How do you post a new question?*

I have been on this website for 40 minutes, unable to find HOW to post a question?!  Try FAQ's, it tells you how to set up a poll, all sorts of things, but I cannot find how to post a question.  can someone please instruct me?  
Thank you!!!


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## Jacoder (Oct 26, 2009)

Renakirk,

At the bottom of the page here you see all the post titles there is a blue button that says, "New Thread". If you are signed in you should be able to click that button and start typing. Hope this helps!

Jennifer


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## FTessaBartels (Oct 27, 2009)

*Starting a new thread*



renakirk said:


> I have been on this website for 40 minutes, unable to find HOW to post a question?!  Try FAQ's, it tells you how to set up a poll, all sorts of things, but I cannot find how to post a question.  can someone please instruct me?
> Thank you!!!



Rena ...
Go to the forum you want to post in ... for example DIAGNOSIS ... and right at the top left you'll see a blue button marked "new thread"
Click that button and start typing. 

F Tessa Bartels, CPC, CEMC


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