Effective October 1, 2009, a new section of E codes has been created to identify the status (e.g., civilian at work, student activity, or military) at the time the injury occurred. These codes are to be used with other external cause codes to indicate the status of the patient at the time of the incident.
New section EXTERNAL CAUSE STATUS (E000) Add Note: A code from category E000 should be used in conjunction with the external cause code(s) assigned to a record to indicate the status of the person at the time the event occurred. A single code from category E000 should be assigned for an encounter. New E000 External cause status category New code E000.0 Civilian activity done for income or pay Civilian activity done for financial or other compensation Excludes: military activity (E000.1) New code E000.1 Military activity Excludes: activity of off duty military personnel (E000.8) New code E000.8 Other external cause status Activity NEC Hobby not done for income Leisure activity Off-duty activity of military personnel Recreation or sport not for income or while a student Student activity Volunteer activity Excludes: civilian activity done for income or compensation (E000.0) military activity (E000.1) New code E000.9 Unspecified external cause status
A 17-year-old male high school student was seen in the emergency department after he tripped and fell on the street and fractured the shaft of the radius and ulna while working delivering pizza. X-rays were taken and he was advised to follow up with the orthopedic surgeon the next day. How should this be coded?
Assign code 813.23, Fracture, shaft, closed, radius with ulna, as the first-listed diagnosis. In addition, assign codes E885.9, Fall from other slipping, tripping, or stumbling; E849.5, Place of Occurrence, Street and highway; E000.0, Civilian activity done for income or pay, and E001.0, Walking, marching and hiking.