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Back  RFI # 537: E-Codes and Diag Pointers

Formal vs. Informal Help Informal Formal

Submitter

Kelly Butler

Description

The 4010 IG makes no mention in the notes as to whether or not it is appropriate for a diagnosis code pointer to point to an E-Code. It only states that an E-Code should not be the primary diagnosis reported on the claim (with a few exceptions). Our thought is that it would not be appropriate for a service line to point to an E-Code. Can you please let us know what the workgroup's position is on this?

Response

The 004010A1X098 Implementation Guide does not address the issue of whether of not it is appropriate to point a service line to a diagnosis containing an E-code. Therefore, it is allowable.
Submission 3/27/2007
Status Date 5/25/2007
Status F - Final
Primary References
Document 004010X098A1
SectionDetail
Page382
Set IDC004
Table2
Loop2400
Segment IDSV1
Element Position07
Industry NameDiagnosis Code Pointer