What Did the Doctor Say to the Insurance Company?

Imagine this:

Jane is a young woman driving herself home from work after a long day. She is exhausted and distracted by her workload. As she approaches a traffic light, the message notification on her phone dings. She quickly glances down instinctively. It’s her husband asking what she what wants to do for dinner.

In that moment, as Jane is trying to multitask between driving, handling her job stress, and her dinner plans, the light changes from green to yellow, then red. But, Jane isn’t paying attention and she passes through the light.

At the same moment, Joe, another driver in cross traffic, too impatient to look for light-runners, hits the gas and travels directly in the path of Jane’s car. The sound of tires screeching, followed by the catastrophic smashing of steel and fiberglass is distinct. It’s a sound everyone has heard at some point.

How Do Medical Providers Document Collision Injuries?

Jane and the other driver are rushed to the hospital. Both have been seriously injured in the accident.

As they are quickly pushed through the doors of the Emergency Room, a nurse is ready to take them in for treatment. They’re rushed to their rooms and attended by the ER staff.

Finally, the attending doctor walks in and talks to each of the injured parties. He makes notes about their injuries, speaks with the nurses, and decides on what needs to be done to treat them.

Here the story diverts attention to the doctor on staff. Doing the things he does, at some point, he is required to report the injuries he saw. He does this by referring to the ICD-10-CM External Cause Codes.

If you just did a double-take on the sudden shift from the dramatic to the cold reality of a doctor’s administrative duties, it’s ok. This article isn’t about Jane and the other injured passenger. It’s actually about how doctors report injuries about vehicle accidents for use by insurance companies.

What is the ICD-10-CM?

The acronym ICD stands for the International Classification of Diseases. It’s a reporting code book for classifying diseases, poisoning, and an extensive variety of other human maladies.

What is most important about what would otherwise be back room medical speak for doctors excited about paperwork, is that the ICD-10-CM is a recent revision. The updated document is more up to date, replacing what some say has outlived its usefulness.

According to an article by the American Academy of Professional Coders (AAPC), the updated ICD-10 allows for a more detailed description of injuries by doctors. This allows for more information about damages sustained in auto collisions.

This is an important factor in how insurance claims are handled when someone is hurt in a car accident. With the updated information, insurance companies have more material to use when assessing claims. What that means for consumers is that, if you are injured in a vehicle related accident, you will want a lawyer to handle your case.

Without an experienced and knowledgeable attorney to review your case, you are more likely to be lost by the excess of technical information. An attorney must identify the additional details covered by ICD-10-CM codes, and create a strategy for fighting for you. Doing this by yourself will more than likely result in failure to collect your fair amount of compensation.

The Legal Implications of ICD-10-CM

So, Jane and the other passenger (we’ll call him Joe), both sustained multiple injuries in their collision. Because Jane ran a red light, and Joe was speeding, they each share partial fault in the damages.

However, ultimately, Jane bears the majority of the fault because her violation was more egregious. Knowing that he is likely to get compensation for his injuries, Joe calls the best personal injury attorney around.

While Joe’s insurance company is offering him a reduced insurance payout, his attorney takes the reigns and tells them “no deal.” After that, it’s a matter of getting the compensation Joe needs to recover from his broken bones and chronic pain issues, including medical care, lost work, auto damages, and more.

The use of the ICD-10-CM External Cause Codes allows the lawyer to break down the details of Joe’s injuries and use them more effectively in court. He can create better estimates of the costs of physical and mental recovery. And he can present the injuries as evidence, allowing considerable advantage to Joe’s case.

While this is all just a hypothetical, the importance of the details is a matter of receiving the financial compensation needed to complete a full recovery from accident injuries. The alternative could mean getting a less than optimal settlement if any at all.

Where Can I Find a Charleston, SC Auto Accident Attorney?

If you or a loved one was hurt or wrongfully killed in a car crash, you need to find legal representation right away. The Hartman Law Firm, LLC knows how to fight for victim’s rights.

To get started, call Frank Hartman24 hours a day, 7 days a week, at (843) 300-7600 for your free legal strategy session. 

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