After a motor-vehicle accident, a third-party auto liability insure…

Question

After a motor-vehicle accident, a third-party auto liability insurer requests ICD external-cause detail and enforces a timely-filing limit different from the patient’s major medical plan. How should the physician coder approach the liability claim?

Accepted Answer

Differentiate auto/liability payer requirements—including external-cause coding and that payer’s timely-filing rules—from standard health-insurance habits. — Auto liability is not just another PPO card. They often want the crash story in the codes and run a different filing clock—treat them as their own rulebook.

Answer

Use only the major medical plan’s timely filing and omit external causes because liability payers never need them.

Answer

Bill the liability claim as an inpatient DRG regardless of the office setting.

Answer

Ignore the auto insurer and always force primary filing to Medicare first.

After a motor-vehicle accident, a third-party auto liability insurer requests ICD external-cause detail and enforces a timely-filing limit different from the patient’s major medical plan. How should the physician coder approach the liability claim?

Short Explanation

Full Explanation