E-CODING

An external cause of injury code or E-code is used when a patient presents to a healthcare provider with an injury. The E-code is part of the World Health Organization’s International Classification of Diseases (ICD) system used in clinical settings to characterize and standardize health events. For clinical settings such as hospital or emergency department visits, the ICD-version 9- Clinical Modification [ICD-9-CM] is being used in the US until October 2014 when it will transition to version 10. For deaths, ICD-10 has been utilized in the US since 1999. ICD-10 and ICD-10-CM no longer refer to these codes as E-codes but as external causes of morbidity and mortality.

The ICD-9-CM E-code explains the circumstances of an injury. E-codes classify injuries according to: 1. Intent (e.g. unintentional, homicide/assault, suicide/self-harm, undetermined) 2. Mechanism (e.g. motor vehicle, fall, firearm, poisoning) 3. Place of occurrence (e.g. playground) 4. Activity (e.g. walking or running)1 E-codes essentially capture the “who, what, where, why, and how” surrounding an injury event.

Managed care A special ICD-9-CM diagnosis code used on the HCFA 1500–the physician claims form, generally to report accidents, injuries or diseases which, for a short period of time, included secondhand smoke; E-codes can be used in conjunction with ICD-9CM codes. See ICD-9-CM. E-codes are used when a diagnostic code indicates an injury. For hospital and emergency department visits, E-codes are used in addition to the diagnostic codes for administrative purposes including billing and reimbursement. Though all states collect E-codes on a mandatory or voluntary basis, E-code data are often incomplete, missing, or incorrect. Complete medical documentation is critical for accurate and detailed E-Coding.

Here is the List of Some E-codes:

E100–E199 (colours)
E200–E299 (preservatives)
E300–E399 (antioxidants, acidity regulators)
E400–E499 (thickeners, stabilizers, emulsifiers)
E500–E599 (acidity regulators, anti-caking agents)
E600–E699 (flavour enhancers)
E900–E999 (miscellaneous)

E-codes are important for hospitals and providers because E-codes can help to ensure timely reimbursement from payers. In the absence of E-codes, payers may request additional information regarding the injury that can be readily supplied by an E-code. If E-codes are not included on a claim, it can delay reimbursement until the payer can obtain the necessary information, usually from the patient or through additional record requests, and determine if there is another party responsible for the claim.2,3

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