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PAP217

E Codes


Provider Administrative Policy

Section
Claims Submission
Policy Date
April 2007
Status/Date
Revised/January 2010
Provider Type(s)
All Providers  

Disclaimer

Our provider administrative policies contain information regarding claims submission, reimbursement, and other information in order to achieve an efficient relationship with our providers. These policies are not an authorization or explanation of benefits. Blue Cross of Idaho retains the right to add to, delete from and otherwise modify this policy in accordance with our provider contracts.

Policy

E Codes

In the ICD-9-CM manual, E codes are described as classifications of external causes of injuries, poisonings and other adverse effects – not diagnoses. Therefore, do not bill an E code to Blue Cross of Idaho as a primary diagnosis. Per ICD-9-CM, E codes are supplementary codes used in addition to a diagnosis code listed in the main chapters of ICD-9-CM.

Blue Cross of Idaho may return or deny claims billed with an E code as the primary diagnosis requesting a valid primary diagnosis from the main chapters of ICD-9-CM.  We will process denials caused by invalid primary diagnosis codes as contractual adjustments for contracting providers.  Blue Cross of Idaho accepts corrected claims in accordance with the time frame stipulated in the provider contract.

For correct coding of accident/injury claims, refer to PAP218.


Policy History

Date Action Reason
January 2010 Revised Processing language added

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