Perhaps this fall into the category of useless information but you never know.  What if you have to code a patient who was being abused by her husband right when a terrorist’s bomb exploded causing the windows to break and cut her.  What if the same person got into her car and drove as fast as she could to get out of there and ended up getting in a dreadful motor vehicle accident. Wouldn’t it be dreadful if while she was unconscious from the auto accident, the flood waters started rising and nearly drowned her.   How on earth would you sort those E codes out?

1. E codes for child and adult abuse take priority over all other E codes.
2. E codes for terrorism events take priority over all other E codes except child and adult abuse.
3. E codes for cataclysmic events take priority over all other E codes except child and adult abuse and terrorism.
4. E codes for transport accidents take priority over all other E codes except cataclysmic events, child and adult abuse and terrorism.

It gets even more complicated if a transportation accident involves more than one type of vehicle.  Spacecraft always comes first followed by watercraft, motor vehicles, trains and other.

Thankfully, the likelihood that you would have to code all of these at one time is pretty slim.  So all you really need to remember is that when using multiple E codes, abuse trumps all and transport accidents are right behind abuse.

Nobody is going to lose any money if you don’t use E codes properly.  You probably will stay off the federal investigator’s watch list if you neglect an E code now and them.  So why should you use them?  The answer is simple.  If your coding paints as complete of a picture as possible of a patient, less attention will be paid to the visit notes.  In Medical Review, only eligibility and reasonable and necessary are scrutinized.  If a reviewer sees a trauma code followed by an E code for an MVA, the reasonable and necessary requirement is very firmly supported.

Plus some of the E-codes are just fun.

• E906.3  (What is an aparthod?)
• E014.1  (A real threat to home health workers)
• E029.2 (Happens everyday)
• E875.0  (Wash your Hands!!)
• E908.8 (Common code last week in some parts)

Don’t forget that you can click on the ‘Ask the Coders’ button on the top bar any time you have a question.