If you’re tempted to stop at the point where the ICD-10 coding guidelines for Chapter 20 say “there is no national requirement for mandatory ICD‐10‐CM external cause code reporting” and think that there’s no need for you to document external causes of morbidity codes for your patients with injuries, you could be forgiven.
But the fact is, if you don’t use codes from the V00-Y99 range to pinpoint “environmental events and circumstances as the cause of injury, and other adverse effects,” you’re not telling the whole story of the patient’s condition. When that happens, you might be creating problems for your practice and your patient. You could also be denying revenue opportunities for your practice and benefits to medical researchers and policy makers, too.
So, what exactly are these codes? More, why are they important? Here are five of the most frequently asked questions about the external cause codes, along with detailed answers to help you know how, when, and why to use them.
Answer: External cause codes “capture how the injury or health condition happened (cause), the intent (unintentional or accidental; or intentional, such as suicide or assault), the place where the event occurred the activity of the patient at the time of the event, and the person’s status (e.g., civilian, military),” according to ICD-10. Some examples include
Answer: ICD-10 guideline 20.a.4 states you should “assign as many external cause codes as necessary to fully explain each cause.”
Answer: ICD-10 guidelines for reporting external causes state that even though “there is no national requirement for mandatory ICD‐10‐CM external cause code reporting,” you may be required to report them when subject to “a state‐based … reporting mandate” or by “a particular payer.” But even if reporting an external cause is not required, doing so is always best practice – and in fact, correct coding.
Answer: This question has two answers:
Answer: Again, there are several answers to this question.
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Nail down correct diagnosis coding with ease in this comprehensive 2019 ICD-10-CM for Physicians & Hospitals that includes coding tips and definitions of medical terms throughout the Tabular List. New chapters are included to introduce you to Risk Adjustment and Hierarchical Condition Categories (HCCs) and MACRA: MIPS and APMs. You can easily prepare for coding certification exams with the expert exam prep tips included in the book, along with 60 stick-on tabs to mark specific sections of the book, making page navigation quick and easy. ICD-10-CM Official Guidelines for Coding and Reporting 2019 are in the front of the book for fast reference and also include flow charts for assigning the correct codes.