Reader Question: ED Physician

Question: Our coding department currently codes for the emergency department (ED) physician professional component. Now were thinking about coding for facility-side services. What should we do to prepare and train for coding under APCs?

Ohio Subscriber

Answer: Coding for facility services differs considerably from professional coding. Although professional component coders may have more experience in coding CPT/HCPCS codes for some departments (i.e., the emergency department), rules for assigning diagnosis codes and modifiers for the hospital are quite different, as are the rules for coding services when the patient is admitted.

Hospital coders also will assign CPT/HCPCS codes for the private physician service provided in the facility for identification under APC billing rules, a departure from the standard ED professional component coding that only identifies services performed by emergency physicians assigned to the emergency department.

You also will have to familiarize your coders with coding for supplies and medications dispensed in the ED.
In general, professional component coders must learn different rules for billing the hospital services.

Both the American Health Information Management Association (AHIMA) and the American Academy of Professional Coders (AAPC) provide training manuals for hospital outpatient coding as well as hospital coding certifications. Other medical coding publishers also provide training manuals to assist you in learning hospital coding principles. The American Hospital Association (AHA) coding clinics are considered the authoritative source for hospital coding and should be referenced by any coder assigning hospital codes.


- Published on 2000-09-01