Ophthalmology and Optometry Coding Alert
Never Use E Codes as Primary Diagnoses
Question: North Dakota Subscriber Answer: Pointer: E codes do not change your reimbursement amount because they are really for information only. You should never report E codes in lieu of a diagnostic code to describe an injury, but E codes help the carrier understand how the patient was injured. They also support the work-related nature of certain injuries to differentiate workers' compensation (WC) care from non-WC care. Although the E codes aren't payment codes, they explain the "environmental events, circumstances and conditions" that caused the injury, states the ICD-9 manual. Therefore, you should never report an E code as your primary diagnosis, but you should instead list it after the main diagnosis. Correct coding requires you to report this added information. The E codes are part of the ICD-9 system, which instructs you to code an encounter as specifically as possible. Agencies also use this supplemental information for statistical purposes. The E codes help public-health officials plan prevention programs and indicate, with diagnosis codes, a classification system for injuries. If an insurer, such as California Blue Cross Blue Shield, routinely rejects claims containing E codes, you'll have to do some extra work to obtain payment, such as by submitting a paper claim with chart notes.
Ophthalmology and Optometry Coding Alert
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