Wiki E Code / Complexity Code

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MCogdill

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Please help settle a debate: pediatric patient comes in for physical. There are the 4 regular codes and an E code for obesity that goes on the complexity code. Another biller says an E code cannot be the first entry on a line, but my contention is it's a continuation of the line above. Correct?
 
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I have no idea what you mean by a 'complexity code' or about a code being the 'continuation of the line above'. But your biller may be confusing ICD-9 with ICD-10. Under ICD-9, 'E Codes' were the external cause codes which were not allowed as a primary diagnosis code. In ICD-10, codes that begin with E are not external cause codes, and may be the first-listed code on any claim or charge.
 
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It is entirely possible that some of this is related to your software and some is lack of coding knowledge somewhere along the line.

you say there are 4 regular codes
Are you referring to the 4 codes maximum that can be linked to a line item CPT code?

then you add that there’s an E code for obesity that goes on the complexity code.
Here is where you are losing us. What is “the complexity code”.
Obesity is an E66.- code and it can be any one of the maximum allowed codes on the claim.
I have never heard of an ICD-10 CM code referred to as a complexity code.
Then you say a biller states an E code cannot be the first entry on a line
All endocrine code are codes that begin with E such as E11.9 for type 2 diabetes
Most E codes are allowed as first listed codes so this statement is definitely puzzling
I still am unclear what you mean when you say it is a continuation of the line above.

if you can clarify these issues we may be able to be of greater assistance
 
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