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ED Coding and Reimbursement Alert
ED Coding and Reimbursement Alert
ED Coding And Reimbursement Alert - 2024; Volume 27, Number 10
Procedure or ED E/M?:
Use This Guidance for Treating Lacerations With Surgicel
Report with wound repair codes, include in E/M code … or something else? Laceration re...
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CPT® Basics:
Decipher the Symbols in Your CPT® Code Book for Easier Code Selection
These notations can help coders better master each code's guidelines and descriptors. E...
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ICD-10 Coding:
Update Your Understanding of Asthma Coding
And don't forget cause/effect sequencing. Earlier this year, the Centers for Disease Con...
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You Be the Coder:
CPR, E/M for CHF Patient
Question: The physician spent 41 minutes treating a patient with chronic congestive h...
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Reader Questions:
Complicated I&D Depends on Physician Judgment
Question: Encounter notes indicate that the ED physician performed an incision and dr...
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Reader Questions:
Use This Primer to Ease Hypertension Coding
Question: What is the difference between essential (primary) hypertension and seconda...
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Reader Questions:
Distinguish NCD From LCD
Question: What's the difference between a national coverage determination (NCD) and ...
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Reader Questions:
Get the 411 on MUE
Question: Could you please clarify what “MUE” means and explain how it impacts m...
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ED Coding And Reimbursement Alert - 2024; Volume 27, Number 9
ICD-10 2025:
ICD-10 Makes Eating Disorders More Specific
Also, synovitis/tenosynovitis combo code expands. ICD-10 has released its list of new, re...
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Medicare Physician Fee Schedule:
Here’s the Big News in the 2025 Proposed Rule
Big surprise: Another rate cut is coming. The Centers for Medicare & Medicaid Service...
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Modifier Madness:
4 Tips to Help You Differentiate Modifiers 76, 77
4 Tips to Help You Differentiate Modifiers 76, 77 Repeat service, but 2 different provid...
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Reader Questions:
Know Difference Between Closed Clavicle Treatments
Question: Encounter notes indicate that a patient suffered from a fracture of their ...
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Reader Questions:
Think Beyond Reimbursement for Z Codes and Medical Necessity
Question: Do Z codes really affect reimbursement, or are they mostly designed to pad ...
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Reader Questions:
Rely on Addendums for EHR Mistake Corrections
Question: How should we correct a mistake in an electronic health record (EHR)? Mont...
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Reader Questions:
Reevaluate the Relationship Between Unlisted Codes and Modifiers
Question: Can I append a modifier to an unlisted CPT® code? I'm having trouble gett...
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You Be the Coder:
Simple or Complicated FBR?
Question: A patient reports to the ED after falling into a pile of branches while lan...
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ED Coding And Reimbursement Alert - 2024; Volume 27, Number 8
Injections:
FYI on TPI: Know When You Can Code These Shots in the ED
Remember to count muscles injected. Therapeutic injections and infusions aren't typically...
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Mythbuster:
Shatter These 4 Myths, Strengthen Signs and Symptoms Smarts
Get the 411 on what to code – and what to leave off – your claims. Choosing the ICD-1...
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Compliance:
Address These Key Fields, Complete ABNs With Ease
Don't forget that every ABN form must be one single page. As every ED practice is aware,...
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Reader Questions:
Choose E/M for Bruised Chest and Ribs Tx
Question: A new patient presents to the ED after falling from a balcony. The patient...
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Reader Questions:
Distinguish Medical Identity Theft From Other Types of Fraud
Question: Is medical identity theft a type of fraudulent claim? Minnesota Subscriber...
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Reader Questions:
Get Delta-Agent Info on Hepatitis Dx
Question: Encounter notes indicate that the ED physician treated a patient with “ac...
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You Be the Coder:
TBSA Counting Methods for Burns
Question: Encounter notes indicate that an adult patient suffered burns to their righ...
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ED Coding And Reimbursement Alert - 2024; Volume 27, Number 7
Fracture Care Coding:
Close Knowledge Gap to Master These Closed Fracture Treatments
Some ED fractures require manipulation; others don't. Two common fracture presentations i...
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Fee-For-Time Billing:
7 Myths and 1 Truth About Fee-for-Time Billing
Prep now for summer fee-for-time fill-ins, previously called locum tenens. Summer vacati...
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Compliance:
Fight for Your Right to Appeal and Win
Insurance companies aren't advocating for your office; that's your job. During her HEALTH...
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Reader Questions:
Don’t Combine Chest Pain, SOB Symptoms
Question: A patient reports to the ED with chest pain and shortness of breath (SOB)....
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Reader Questions:
Get the Skinny on Medicare Overpayment Timeline
Question: We've heard that Centers for Medicare & Medicaid Services (CMS) says we...
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Reader Questions:
Be Careful With Complexity for Undiagnosed Condition
Question: Does an undiagnosed new problem with uncertain diagnosis automatically mean...
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You Be the Coder:
A-lines and Critical Care
Question: A patient with acute respiratory failure with hypoxia is brought to the ED ...
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ED Coding And Reimbursement Alert - 2024; Volume 27, Number 6
Condition Spotlight:
Cool Off Burn Coding Concerns by Knowing Treatment Types
Know when to report a procedure code for burn care. In the last issue, we ran down the m...
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Modifiers:
Avoid These 5 Modifier 59 Errors to Keep Pay Flowing
Plus: Find out the 2024 news that changes one modifier 59 rule. What would you do if 40...
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Compliance:
Study These Strategies for Setting Up a Solid CDI Process
Realize the benefits of regular self-audits. Comprehensive clinical documentation is the ...
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Reader Questions:
Know Thoracentesis Definition for Clearer Coding
Question: Encounter notes indicate that the ED physician inserted a long needle into ...
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Reader Questions:
Make Friends With ‘Buddy Taping’ Code
Question: If the ED physician wraps tape around an injured toe and an adjoining one t...
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Reader Questions:
Define Stable Condition
Question: Is there any difference between a chronic condition and a stable condition,...
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Reader Questions:
Use NOS Code for Backache Dx
Question: If a patient is diagnosed with “backache” and there is no other informa...
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You Be the Coder:
Is This an Intubation?
Question: A patient is brought to the ED with chronic obstructive pulmonary disease (...
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ED Coding And Reimbursement Alert - 2024; Volume 27, Number 5
ICD-10 Coding:
Follow These Steps to Burn Coding Success
Corrosion or burn? Here's why it matters. Patients who report to the ED with burns have a...
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E/M Coding:
Take a Second Look at MDM Table
Does data factor into this ED E/M claim? Given the recent and extensive changes to the ev...
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Cybersecurity:
Stay on Top of Cyber Threats As You Introduce New Tech and Services
Bookmark the HC3 webpage for quick access to federal guidance. With the rise of telehea...
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Reader Questions:
Keep CPR, E/M Separate
Question: Can I report an ED evaluation and management (E/M) code along with a code for ca...
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Reader Questions:
Medicare Ups Conversion Factor … Slightly
Question: Has there been any change to the Medicare Physician Fee Schedule (MPFS) conversi...
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Reader Questions:
Gather Info for Accurate AAA Dx
Question: A patient reports to the ED with complaints of severe back pain, clammy skin, an...
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Reader Questions:
Know When ‘Procedures’ Don’t Get Procedure Codes
Question: One of my providers recently removed an ear piercing, and he documented that “...
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Reader Questions:
Determine Whether to Code Dementia With Alzheimer’s Diagnosis
Question: Dementia is a symptom of Alzheimer's, so does that mean I can't code them togeth...
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You Be the Coder:
Fracture by Assault
Question: Encounter notes indicate that a patient reported to the ED after someone assault...
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ED Coding And Reimbursement Alert - 2024; Volume 27, Number 4
News You Can Use:
Use Updated Guidelines to Allow for Multiple Unlisted Procedures
Also, CPT® updates modifiers you can — and can't — use with unlisted codes. If...
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ICD-10 Coding:
Prep for Warm-Weather ED Presentations With These Tips
Anaphylactic shock a factor in insect bite coding. It seems to be getting warmer earlier...
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Case Study Corner:
Listen Up for Cerumen Removal Advice
Do you know what instruments the physician might use? When a patient reports to the ED ...
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Reader Questions:
Drill Down for Details on Head Crush Injury
Question: Encounter notes indicate that a patient suffers from a crushing injury of t...
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Reader Questions:
Make Modifiers Work for You on Lesion Removal
Question: After a level-three ED evaluation and management (E/M) service, the physici...
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Reader Questions:
Note Procedure Details to I.D. Abscess Drainage Type
Question: What is the difference between a simple and complicated finger abscess drai...
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You Be the Coder:
ED E/M With Critical Care
Question: A patient reports to the ED with chest pain. During the course of an ED eva...
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ED Coding And Reimbursement Alert - 2024; Volume 27, Number 3
Injection Coding:
Know Joint Size for Accurate Arthrocentesis Coding
Use nebulous CPT® descriptors as guidepost for other joints. Patients who report to the ...
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ICD-10 Coding:
Get Specifics to Nail Hypertensive Disease Dx
Here's the code to use for essential hypertension. When patients are suffering from a hyp...
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E/M Coding:
Rehash Hospital Coding Rules to Ensure Compliance
Do you know which hospital services share codes now? In case you haven't noticed, CPT® ...
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Reader Questions:
Never Report Prolonged ED E/M Services
Question: Is there a way to account for extra time on an ED evaluation and managemen...
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Reader Questions:
Know Complication Type to Choose Dx
Question: If a patient suffers from an intra- or postoperative complication involving...
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Reader Questions:
These 2 Effusions Get 1 ICD-10 Code
Question: If a patient suffers from effusion of the same ankle and foot, should I sub...
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Reader Questions:
Know Stages for Optimal Pressure Ulcer Coding
Question: If a patient has a pressure ulcer on their back, what is the difference amo...
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You Be the Coder:
Critical Care Time
Question: I have an encounter form in front of me that's a bit confusing. Notes indic...
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ED Coding And Reimbursement Alert - 2024; Volume 27, Number 2
E/M Coding:
Time Is of the Essence When Reporting Critical Care
Know how to count critical care minutes. Proper documentation and coding of critical care...
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Compliance:
Make Sure Fairness Marks Sanction Policy
Tip: Ensure employees receive training equivalent to their duties. Data breaches are ser...
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ICD-10 Coding:
Use These Tips to Get Top Neurology Diagnoses Out of Your Head
Do you know how to code headache syndromes? In an ED, there are going to be a number of...
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Reader Questions:
Get More Info to Before Picking PICC Code
Question: Encounter notes indicate that the ED physician inserted a peripherally inse...
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Reader Questions:
Report Manipulation Along With Palmar Fascial Cord Injection
Question: Encounter notes indicate that the ED physician injected collagenase for a ...
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Reader Questions:
Don’t Treat All Fatigue Syndromes the Same
Question: Are all fatigue syndromes the same, for diagnosis purposes? For example, if...
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You Be the Coder:
Separate E/M With Minor Procedure
Question: A patient reports to the ED with an ingrown toenail. During the exam, the p...
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ED Coding And Reimbursement Alert - 2024; Volume 27, Number 1
2024 MPFS:
CMS Aligns With CPT® on Split/Shared Visits
See how the change will affect MDM scoring. In 2024, the stars will align and CPT® and M...
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2024 MPFS:
CMS Follows Through With CF Cut
Here's what factored into the final decrease. It's happened again. With no one displayi...
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Procedure Coding:
Spark Your Burn Coding With CPT® Smarts
Do you know when burn Tx isn't reported with a burn Tx code? When a patient reports to th...
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Reader Question:
Know Specifics of Chickenpox for Optimal Code Selection
Question: Encounter notes indicate that the ED physician treated a patient with “cx...
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Reader Question:
Allergy to Cement? Report This Dx
Question: When a patient has allergic contact dermatitis to cement dust, how should I...
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Reader Question:
Code Carefully When Considering CPR/Critical Care Combo
Question: Encounter notes indicate that the ED physician performed 43 minutes of crit...
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Reader Question:
Consider Independent Historian When Seeking Px Info
Question: I am working as a coder for the first time and one of my providers wrote th...
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You Be the Coder:
Multiple Laceration Repairs
Question: Encounter notes indicate that the ED physician treated two wounds to a pati...
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ED Coding And Reimbursement Alert - 2024_October
Emergency Department:
Consider Complexities of Encounter on Nosebleed, Earwax Encounters
Remember the rules for procedure coding on these common services. Sometimes, how you code...
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ED Coding And Reimbursement Alert - 2024_October
Emergency Department:
Repeat Rabies Vax Presents E/M Coding Challenges
Question: Our office is currently engaged in a debate regarding the appropriate codin...
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ED Coding And Reimbursement Alert - 2024_October
Emergency Department Coding:
Check 5th Character Requirements on Liver Disease Dx
Question: When a patient suffers from alcoholic liver disease, what is the best way t...
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ED Coding And Reimbursement Alert - 2024_November
Emergency Department Coding:
2 ED E/Ms in 1 Day? Not So Fast
Question: A patient reported to the emergency department (ED) at 7 a.m. for fever, nausea,...
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Emergency Department Coding:
Take Your Time to Nail FAST Exam Coding
Remember, a high-level ED E/M will likely occur during these encounters. When a patient p...
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ED Coding And Reimbursement Alert - 2024_November
Emergency Department Coding:
Get Your Head Right on These Diagnoses
Question: We're having trouble getting our headache and migraine ICD-10 coding straight. B...
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