A FALSE statement about external cause codes is: a. Assign as many external cause codes as necessary to fully explain each cause b. An external cause code can never be a principal (first-listed) diagnosis c. There is a national requirement for mandatory ICD-10-CM external cause code reporting d. Assign the external cause code, with the appropriate 7 th character (initial encounter, subsequent encounter or sequela) for each encounter for which the injury or condition is being treated
The correct answer and explanation is:
Correct Answer: c. There is a national requirement for mandatory ICD-10-CM external cause code reporting
Explanation:
External cause codes in the ICD-10-CM coding system provide information about the cause of an injury or health condition, such as the mechanism (e.g., fall, motor vehicle accident), the place where the event occurred, and the activity the patient was involved in. These codes are secondary and are used in combination with diagnosis codes to offer more context about the injury or condition.
The false statement is option c, which claims that there is a national requirement for mandatory reporting of these codes. In truth, external cause code reporting is not mandated at the national level in the United States. Instead, it is voluntary unless required by a state, payer, or specific healthcare setting. Some states or institutions may have their own rules requiring the use of external cause codes, especially for trauma reporting or public health surveillance, but this is not universally mandated nationwide.
Now let’s review the other options to show why they are true:
- a. Assign as many external cause codes as necessary to fully explain each cause: This is accurate. Coders are encouraged to use multiple codes if needed to capture the full picture of the external circumstances of an injury.
- b. An external cause code can never be a principal (first-listed) diagnosis: This is also true. External cause codes are supplementary and are never listed as the primary diagnosis. They only add additional context.
- d. Assign the external cause code, with the appropriate 7th character (initial encounter, subsequent encounter or sequela) for each encounter for which the injury or condition is being treated: This is correct. The seventh character is crucial to specify the stage of treatment.
In summary, the incorrect or false statement is option c, because national use of external cause codes is not mandatory.