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ED Coding and Reimbursement Alert

Top ED Code Changes for 2004
Gear up for a new array of venous access codes Revamped radiology, critical care, and ven... Read more
Burn Diagnosis Coding:
It's as Easy as 1, 2, 3
Don't let burn coding beat you; follow these steps for an easy path to reporting When a p... Read more
Be Sure to Cover All Areas When Burn Coding
Don't send off that claim until you've checked for billable ancillary services Once you'v... Read more
Burn Diagnosis Coding Quiz
Test your skill on scenarios using the 940-947 code set Now that you've had a crash cours... Read more
Reader Question:
Pay Attention to Detail With Infusion Coding
Question: A patient presents with an allergic reaction that resulted in throat swelling, p... Read more
Reader Question:
Maximize Payment Potential in Fracture Coding
Question: A patient presented with an injured arm, which the physician discovered was brok... Read more
Reader Question:
Cleaning Extensive Debris Can Elevate Codes
Question: A patient presented with a long laceration on her leg caused by a broken pane of... Read more
Reader Question:
Watch the Clock When Coding Critical Care
Question: A patient was brought into the emergency department with CPR in progress. Our ph... Read more
You Be the Coder:
Repeat Visits During Global Periods
Question: Six days ago, our physician saw a patient for drainage of a complicated abscess ... Read more
Beware Latest NCCI Edits:
6 New Bundles Affect Ultrasound, E/M Coding
Updates to the National Correct Coding Initiative (NCCI) can be a real headache for physic... Read more
Identify Critical Care and Receive Vital Payment Boost
Most emergency department (ED) coders are familiar with the standard scenarios in which cr... Read more
Quick Quiz on Critical Care Coding
No one wants to go to the trouble of filing a claim only to have it rejected, especially o... Read more
Never Report -22 Unless You've Done These 4 Things
If you're submitting a claim for unusual procedural services without first determining how... Read more
News You Can Use:
CMS Posts NCCI on Internet - Free!
CMS has made it easier for physicians and other providers to bill properly - and be paid p... Read more
Reader Question:
Be Careful Identifying Post-Op Care
Question: A patient presented with a leg abscess, which the physician drained and packed. ... Read more
Reader Question:
Watch Out When Billing Extended Observations
Question: A patient presented to the ED complaining of chest pain at 8 a.m. The physician ... Read more
You Be the Coder:
Coding an Interrupted Lumbar Puncture
Question: A physician attempted a lumbar puncture on a patient. During the procedure, the ... Read more
Sew Up Payment Gaps in Suture Removal Services
Know your options when services don't go as planned Laceration repair is invariabl... Read more
Hone In on MDM When Coding Migraines
You know the key factors for applying evaluation and management (E/M) codes - history, exa... Read more
Go Electronic With Your Medicare Claims
Final rule from CMS mandates e-claims this fall If you don't submit your claims electroni... Read more
Test Yourself:
Suture Removal Coding
Not all suture removals are the same - so take this quiz and find out if you know how and ... Read more
Reader Question:
Don't Report Splinting for Ace Wrap
Question: A patient presented in the ED with a  diagnosis of "ankle sprain." The ED d... Read more
Reader Question:
Include Anesthesia in Multiple Abscess Drainage
Question: Our ED physician documented two incision and drainage procedures on the patient'... Read more
Reader Question:
Report ED E/M Code for Observation Services
Question: Our ED physician admitted a patient to observation and later discharged him. The... Read more
Reader Question:
Include Vessel Repair in Closure Services
Question: I am having difficulty determining whether this physician's note documents an ar... Read more
Reader Question:
Count Acuity Caveat for HPI
Question: Can the acuity caveat apply to the patient's history of present illness (HPI)? W... Read more
Reader Question:
Add E Code for Injury Dx
Question: Is there an ICD-9 code that describes a transmetatarsal amputation due to a crus... Read more
Reader Question:
Choose Debridement Over Amputation
Test your coding knowledge. Determine how you would code this situation before looking a... Read more
You Be The Coder:
Place of Service and 36430
Question: I billed 36430-59 with place of service 23 (Emergency room - hospital). Medicare... Read more
Deliver Pregnancy Ultrasound Payment That's Anything but Routine
Nix Certain US Codes When Patient Presents in ED You know the routine: A pregnant patie... Read more
When the Patient Leaves the ED, Don't Leave Out -52 and -53
CompleteYour Claims for Incomplete Procedures Your physician may have to stop treating ... Read more
Test Yourself:
Modifier -52 Versus Modifier -53
Think you know when to report reduced services and when to report a discontinued procedure... Read more
Hot Tips to Melt Your Payer's Cold Shoulder
Avoid Modifier -52 and -53 Denials With These 3 Guidelines You've decided between mod... Read more
Don't Skip the Fine Print With New ICD-9 Codes
Details Make or Break New Concussion and Sickle-Cell Codes Diagnosis codes for 2004 tak... Read more
Reader Question:
Stick to 99291 and 99292 for Critical Care
Question: In the December 2002 issue of ED Coding Alert, you discussed new pediatric cri... Read more
Reader Question:
Any Doctor Can Bill for TPA
Question: We are having a problem getting reimbursed for coronary thrombolysis procedure... Read more
Reader Question:
Use 640.0 for Vaginal Bleeding
Question: What is the proper way to code the following scenario? "A term-pregnancy patie... Read more
Reader Question:
Check With Carrier for PA Payment
Question: I'm having difficulty getting reimbursed for the work of our physician assista... Read more
You Be the Coder:
Observation - Who Bills?
Question: Our doctor treated a patient in the emergency department (ED), and he admitted t... Read more
Are You Billing for Burns Correctly? Not if Youre Overlooking the 16000 Series
You may mistakenly believe you should report an E/M code (99281-99285) only for emer... Read more
Are Your Diagnosis Codes Feeling the Burn?
Assigning the appropriate diagnosis codes is an integral part of your burn coding. ICD... Read more
Youd Be Crazy to Leave Your Psych Coding in the Dark
Since your emergency department (ED) physician probably performs several psychiatric eva... Read more
Dont Skimp on Critical Care for Anaphylaxis Patients
If you're overwhelmed every time you have to decipher codes for anaphylactic patients,... Read more
Reader Question:
Assign E/M for Non-Starred Suture Repair
Question: Our ED physician saw a patient for a suture repair and told her to come back in ... Read more
Reader Question:
Hematoma Blocks Included in Manipulation
Question: How should I bill for hematoma blocks? Is there a certain CPT series and is it c... Read more
Reader Question:
Use 93307 With Portable ECG Machine
Question: How should we report using a portable echocardiograph machine?Utah Subscriber A... Read more
Reader Question:
Layers Determine Repair Complexity
Question: We often code laceration repairs. How can we easily tell the difference among a ... Read more
Reader Question:
Follow Procedure for Locum Tenens
Question: How should I bill for a locum tenens who has temporarily replaced a physician wh... Read more
You Be the Coder:
ECGs Reimbursed Only Once
Question: How can we receive reimbursement for 93010 and 93042 in the emergency department... Read more
Cardioversion Denials Raising Your Blood Pressure? Find Out Where Youre Going Wrong
If you're not clear on what separates cardioversion from defibrillation, let ... Read more
How to Capture Pay for Cardioversions, Defibrillations
Once you've distinguished between cardioversions and defibrillations, chemical and electri... Read more
Use Only Physical Evidence to Determine Rape
It's a situation no healthcare professional wants to encounter, but the reality is, pati... Read more
Case Study:
Are You Making the Most of
Translating coding advice into practice means whipping out the patient encounter forms a... Read more
Reader Questions:
Bill Critical Care Under One PIN
Question: Our ED physician saw a patient in the morning for a critical care service. Lat... Read more
Reader Questions:
Let the Star Guide You Except When Reporting to Medicare
Question: If a patient presents in the ED for a gastro tube change, can I bill the tube ... Read more
You Be the Coder:
When You Cant Get MDM to Add Up
Question: A 20-year-old patient presents to the ED with a fever of 105 and body aches. The... Read more
Zero In on EKG Payment:
Reports,Strips and Critical Care
Fight for electrocardiogram (EKG) interpretation payment in the ED otherwise, Medic... Read more
Avoid the Red:
Understand Your Liability as a Coder
If you think lawsuits happen only to physicians and hospitals think again. Your cod... Read more
Weigh In on the EKG Battle:
Do Your Part
Your job is to ensure your physicians get paid fairly. When you report EKG interpretat... Read more
Reasons to Avoid Sloppy or Inaccurate Coding
There's nothing better than a list of consequences to whip any coder into shape. You m... Read more
For ED Coders Only:
NPP Tips You Cant Miss
Although mid-level providers assist your physicians, they can handicap your coding... Read more
Reader Question:
Deliver Consultation Codes for Work Outside ED
Question: A patient in labor is admitted directly to the labor and delivery ward witho... Read more
Reader Question:
Dont Back Away From Burn Codes
Question: A patient presents with second-degree burns on the forearm. The physician di... Read more
Reader Question :
Use Documentation From Entire Chart
Question: A patient presents to the ED because a glow stick broke and splashed her i... Read more
Reader Question :
Use Common Courtesy for the Dead
Question: Our ED physician visits an admitted patient dying of cancer and declares t... Read more
Reader Question:
Give Docs a Last-Chance Look-Over
Question: One of our physicians frequently forgets to check all the elements he review... Read more
You Be the Coder:
Breathe Easy With Nasal Approach
Test your coding knowledge. Determine how you would code this situation before looking... Read more
Break Bad Coding Habits With Fracture Care Answers
If you receive only a fraction of your fracture care reimbursement, read these Q &... Read more
Reduce Denials for Splint and Strap Fracture Care
Call it splitting hairs, but you should know the difference between splinting and stra... Read more
Train Physicians to Repair Fracture Care Documentation
You can't manipulate documentation to get payment for fracture care services. But you ... Read more
Beyond the Basics:
Zero In on the Acuity Caveat: Documentation Details
Even the most experienced coders are no exception to the rule: Everyone can benefit fr... Read more
Reader Question:
Plug Up Lost Nose Revenue
Question: What is the minimum requirement for reporting 30901? Is packing the bare min... Read more
Reader Question:
Remove Thoracentesis Uncertainty
Question: How should I code the following situation: The physician uses the thoracente... Read more
Reader Question:
Straighten Out Those Tourniquet Cases
Question: The patient presents with a hair tourniquet. I can only report a nonspecific... Read more
Reader Question:
Use Anoscopes Broad Range
Question: Our ED physician placed a Parks retractor obtained from surgery. The anorect... Read more
Reader Question:
Report With AnesthesiaServices
Question: I was taught that procedures "with anesthesia" take place in the operating r... Read more
You Be the Coder:
Master Modifiers for CPR
Test your coding knowledge. Determine how you would code this situation before looking... Read more
Clean Up Simple Laceration Claims and Get the Payment You Deserve
Simple laceration repairs may be relatively easy for your ED physicians, but they'... Read more
Bump Simpleto Intermediate, When Appropriate
You can get simple laceration repair claims paid, but you may not obtain optimal ... Read more
Remove Foreign-Body Billing Woes With Coding Examples
Reporting foreign-body removal (FBR) services can be a royal pain in the neck for ED... Read more
Check Your States UPPL Laws
The following states have laws modeled on the Uniform Accident and Sickness Policy Pro... Read more
Sobering News:
Strategies for Alcohol and Drug Intoxication
Alcohol and drug intoxication have caused enough damage to your patients don't let th... Read more
Reader Question:
Avoid Charging Most ED Nebulizer Treatments
Question: Our ED physician performs nebulizer treatments. What documentation gets th... Read more
Reader Question:
Report Intubation Alone
Question: Our ED physician was called to the intensive care unit (ICU) to intubate a p... Read more
Reader Question:
Watch Those Observation Codes
Question: How should I bill the following scenario?: A patient was admitted to the ED ... Read more
You Be the Coder:
How to Report ED Lab Work
Test your coding knowledge. Determine how you would code this situation before looking... Read more
Say Goodbye to Underpaid E/M Claims
Many emergency department visits could score a level-four or -five E/M code, b... Read more
Fight for Your Modifier -25 Claims with These 4 Simple Suggestions
Who knew that one little modifier could do so much damage for ED coders? But put m... Read more
Dont Believe the Myth of Double-Dipping
Double-dipping is not just a social faux pas; it can get your practice into complian... Read more
Take Advantage of New ICD-9 Opportunities
The new ICD-9 codes for 2003 came out a few months ago, and they bring good news t... Read more
New ICD-9 Codes You Should Note for the ED
Here are the new ICD-9 codes you should note for ED claims, suggested by Robert Po... Read more
Reader Question:
Resolve Coding Disagreement with Physicians
Question: We disagree with our emergency physician's documented level of care ... Read more
Reader Question:
Clear Your Claims for Dental Nerve Blocks
Question: A patient presents in the ED with a toothache. The ED physician perfor... Read more
Reader Question:
For Some Payers,Special Services Apply to ED
Question: At a recent emergency medicine coding conference, I was encouraged t... Read more
Reader Question:
Dont Always Expect Standby Reimbursement
Question: If a radiologist asks one of our ED physicians to render standby servi... Read more
Reader Question:
Dont Bill for Extra Consultation Time
Question: One of our physicians spent 30 minutes speaking with a suicidal patient ... Read more
Reader Question:
Conquer Template Quirks and Confusion
Question: Do I have to find a record of an x-ray being ordered on the docume... Read more
You Be the Coder:
Cure Your Laceration Headaches
Test your coding knowledge. Determine how you would code this situation without lo... Read more
When You Can Report Conscious Sedation as Anesthesia
It seems too good to be true you can report an anesthesia code for conscious sedation... Read more
The Global Surgical Package Unwrapped
Questions about the global surgical package keep coming in from emergency depa... Read more
Surgical Procedure Code + E/M Code Can Be Correct Coding
When can you report both an E/M code and a surgical or procedure code for the same v... Read more
ED Coders,Expect Less Documentation from Your Physicians
Last November, the Department of Health and Human Services released a Medicare transmi... Read more
Documentation Scenarios for New Guidelines for Teaching Physicians
The new teaching physician guidelines will reduce, but not eliminate, teaching phy... Read more
Documentation Faux Pas for New TP Guidelines
For the new teaching physician guidelines, some documentation decisions do not pass mu... Read more
Stamps for Your New TP Documentation
The new teaching physician guidelines mean sparser physician notes. So do stamps now s... Read more
You Be the Expert:
TP Rules:Not for Medical Students
Test your coding knowledge. Determine how you would code this situation before l... Read more
Out with the Old,in with the New
The new template you can expect from teaching physician documentation, mentioned in th... Read more
News You Can Use:
Pediatric Codes,OIG
As we plow forward into 2003, an avalanche of news follows in the New Year's wake a... Read more
Reader Question:
Other Changes Covered by TP Rules
Question: Our practice has heard about the main change under the new teaching physicia... Read more
Reader Question:
Documentation Scenarios from Transmittal 1780
Below are the three scenarios that CMS offers for teacher physician guidelines verbati... Read more
Reader Question:
Definition of Distributive Shock
Question: What is distributive shock? Our physician describes it as secondary to an ea... Read more
Reader Question:
Multi Trauma Visits Require High Decision-Making
Question: Patients with multiple trauma from a fall or motor-vehicle accident arrive b... Read more
Reader Question:
Technical Terms for Falling Down
Question: A patient presents after a fall that occurred at work. The physician dictati... Read more
Reader Question:
CMS versus CPT for E/M Services
Question: Is there a difference between using CMS and CPT guidelines for E/M services?... Read more
Reader Question:
Document the ElectiveStatus of Cardioversion
Question: The definition of cardioversion 92960 reads in part, "elective, electrical c... Read more
You Be the Coder:
Laceration Codes with or without -54
Test your coding knowledge. Determine how you would code this situation before looking a... Read more
The Devils in the Details When Reporting Observation Codes
Emergency department physicians devote crucial time to monitoring patients when ... Read more
Observation Codes:
Details to Note
Reporting observation codes requires more than just designating the code. Watch out fo... Read more
The Right Path to Observation Code Payment
Walk the chosen path to observation care payment: Follow the "TAO" guidelines pres... Read more
The Key to Pulse Oximetry Coding:
Zoom In on Payer Policies
Payment for pulse oximetry varies widely from payer to payer, so pay close attention... Read more
The 411 on Patient Discounts
The emergency department must see and treat every patient until they are stabilized e... Read more
Reader Question:
The 1997 Guidelines Can Prove Helpful
Question: A patient came to the ED with a foreign body in his eye. The emergency... Read more
Reader Question:
When Substance Drained Is Incidental
Question: A physician performed electrocautery of a subungual abscess, but I can... Read more
Reader Question:
Intubation:Always an Emergencyin the ED
Question: If a patient in the ED has a mandible fracture and the physician preform... Read more
Reader Question:
Vermilion Lipstick Traces
Question: One of our physicians treated a patient who had a vertical l... Read more
Reader Question:
Irrigation as Separately Billable Service
Question: Our physicians use "Foley irrigation" or "irrigation via catheter" for som... Read more
You Be the Coder:
Choose Debridement Over Amputation
Reviewed on May 12, 2015   Test your coding knowledge. Determine how you would ... Read more
Available Years:  2003  2002  2001  2000  1999  1998