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ICD-9 is the standard diagnostic coding used by providers and carriers.
CPT-4 is the treatment code.
If ICD-9 is for a sprain then it's a non-emergency in most cases. If it is for chest pains, it is an emergency.
So maybe the coding from the ER/hospital needs to be done differently so the claim rejection for ER to hospitalization claim is not rejected. That is what it sounded like from the claim reps, that the carrier needed more info about the reason(s) for hospitalization. That's not how the letter to the policyholder read, that's what claims said when we called.