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Back  RFI # 1448: 5010 837P E-Code

Formal vs. Informal Help Informal Formal

Submitter

Donnelly Michele

Description

The TR3 for 5010 professional claims does not include an HI segment for External Cause Codes. Qualifier BN is not valid for use in the Diagnosis Code HI segment.

The 4010 guide included a data element note allowing E Codes to be billed in the Diagnosis Code segment using the BF qualifier but that note is removed in 5010 TR3 for professional claims.

How can I bill E-Codes in a 5010 professional claim?

Submitter Assigned Keywords

5010 837P ECode

Response

There is no difference between 4010 and 5010 as to how diagnosis codes are reported. The note was deleted because diagnosis coding must be done according to ICD guidelines and the opinion expressed in the note is not relevant.

Recommendation

Continue to code according to ICD guidelines and complete the HI segment the same as has been done for 4010.
Submission 11/15/2011
Status Date 1/4/2012
Status F - Final
Primary References
Document 005010X222
Section2.3.2
Loop2300
Segment IDHI