Wiki External Codes

[RACOBB]

When coding injury codes is it mantatory to use all external, activity and place of occurances? I know our coding system request we use the external cause, but again must we code all 3? Many times we don't have it documented where the injury took place or the activity for example. I have heard some Coders just using an Uspecified Code if documenttaion is not stated. Does anyone have the knowlege of what ICD.10 requirements are?

Thank you,
Coder

 

[thomas7331]

You'll find this guidance in the ICD-10-CM Official Guidelines for Coding and Reporting at the beginning of your code book in the section on Chapter 20:

There is no national requirement for mandatory ICD-10-CM external cause code reporting. Unless a provider is subject to a state-based external cause code reporting mandate or these codes are required by a particular payer, reporting of ICD-10-CM codes in Chapter 20, External Causes of Morbidity, is not required. In the absence of a mandatory reporting requirement, providers are encouraged to voluntarily report external cause codes, as they provide valuable data for injury research and evaluation of injury prevention strategies.

 

[TThivierge]

External Diagnostic Codes

Hi

I disagree. I believe you should use external dx. codes related to the patient''s injury due to a fall, dog bite, car accident, or ETC. It must of course be listed in physician 's documentation for the date of visit and POC (place of occurrence) of the street, park, in the home, ETC. And these external dx. codes should be listed last on the claim regarding the sequencing. Insurance companies do want this data to give explaining of up to date detailed medical record from your doc or provider. The date of incident should be in physician notation and how injury happen plus place of incident. This info should be filled out on claim too on certain fields on the CMS 1500 (outpatient)or the UB92 (inpatient) blocks. If it a injury diagnosis, the insurance payer probably will sent it back as denial wanting more data. Just saying

Have a great day!

 

[ellzeycoding]

Hi

I disagree. I believe you should use external dx. codes related to the patient''s injury due to a fall, dog bite, car accident, or ETC. It must of course be listed in physician 's documentation for the date of visit and POC (place of occurrence) of the street, park, in the home, ETC. And these external dx. codes should be listed last on the claim regarding the sequencing. Insurance companies do want this data to give explaining of up to date detailed medical record from your doc or provider. The date of incident should be in physician notation and how injury happen plus place of incident. This info should be filled out on claim too on certain fields on the CMS 1500 (outpatient)or the UB92 (inpatient) blocks. If it a injury diagnosis, the insurance payer probably will sent it back as denial wanting more data. Just saying

Have a great day!

I both agree and disagree.

You can and probably should, but the use of External Cause codes is not required according to CMS and ICD-10 Guidelines. That was the question. Is it required? Bottom line. NO.