ED Coding and Reimbursement Alert
Think Twice Before Billing for ED Ultrasounds
New introduction to US section in CPT 2005 creates hurdlesUsher in the new year - sans gra... Read more
New introduction to US section in CPT 2005 creates hurdlesUsher in the new year - sans gra... Read more
What's the Definition of a Neonate?
CPT lines up neonatal codes with ICD-9, WHO's time frame If you've struggled ... Read more
CPT lines up neonatal codes with ICD-9, WHO's time frame If you've struggled ... Read more
Don't Jump the Gun With Wound Coding
Treatment doesn't always include explorationWhen a patient presents in the ED with a wound... Read more
Treatment doesn't always include explorationWhen a patient presents in the ED with a wound... Read more
Reader Question:
Include Controlled Substances in MDM
Question: What standard should I follow when claiming fracture care with an E/M code? I re... Read more
Include Controlled Substances in MDM
Question: What standard should I follow when claiming fracture care with an E/M code? I re... Read more
Reader Question:
Collect 3 PFSH for High-Level Observation Codes
Question: When using either set of observation codes (99234-99236 or 99218-99220) in... Read more
Collect 3 PFSH for High-Level Observation Codes
Question: When using either set of observation codes (99234-99236 or 99218-99220) in... Read more
Reader Question:
Make Pronouncement Free of Charge
Question: How should I code for a patient who presented to the ED with cardiac arrest and ... Read more
Make Pronouncement Free of Charge
Question: How should I code for a patient who presented to the ED with cardiac arrest and ... Read more
Reader Question:
Consider Payer for Lip Repair Code
Consider Payer for Lip Repair Code Question: A patient had a through-and-through lip lace... Read more
Consider Payer for Lip Repair Code
Consider Payer for Lip Repair Code Question: A patient had a through-and-through lip lace... Read more
Reader Question:
Choose 20950 for Interstitial Pressure
Question: I was unable to locate a CPT procedure code for checking compartment syndrome pr... Read more
Choose 20950 for Interstitial Pressure
Question: I was unable to locate a CPT procedure code for checking compartment syndrome pr... Read more
Reader Question:
Don't Forget Extra CPR Services
Question: A critical care patient presented in the emergency department, and the physician... Read more
Don't Forget Extra CPR Services
Question: A critical care patient presented in the emergency department, and the physician... Read more
Reader Questions:
Verify Rules Before Using-47 and Anesthesia Codes
Question: Because conscious sedation codes only apply when a patient is still verbally res... Read more
Verify Rules Before Using-47 and Anesthesia Codes
Question: Because conscious sedation codes only apply when a patient is still verbally res... Read more
You Be the Coder:
Watch Out for Physician Variation in Head Injury Documentation
Question: Which ICD-9 code should we report for a closed head injury""? There ... Read more
Watch Out for Physician Variation in Head Injury Documentation
Question: Which ICD-9 code should we report for a closed head injury""? There ... Read more
Case Study:
Chest Pain and Observation
When the heart is weak, report high-level E/M confidentlyChest pain is always an emergency... Read more
Chest Pain and Observation
When the heart is weak, report high-level E/M confidentlyChest pain is always an emergency... Read more
Make Time for Critical Care Reporting
Every minute counts in preventing costly 99291 denials The trick to securing reimbursemen... Read more
Every minute counts in preventing costly 99291 denials The trick to securing reimbursemen... Read more
Squash These Critical Care Myths
3 hang-ups could lose you $240 per sessionBefore you decide not to submit a claim for crit... Read more
3 hang-ups could lose you $240 per sessionBefore you decide not to submit a claim for crit... Read more
2 Cases Demonstrate the Ins and Outs of Foreign-Body Removal
If you think FBR codes are all about anatomic site, you're bound to miss the reimbursement... Read more
If you think FBR codes are all about anatomic site, you're bound to miss the reimbursement... Read more
Reader Question:
Check Chart for Combo Code
Question: A patient with blood in her stool and diverticulosis presented in the ED. The ph... Read more
Check Chart for Combo Code
Question: A patient with blood in her stool and diverticulosis presented in the ED. The ph... Read more
Reader Question:
Pass Up Payment for Phone Advice
Question: Should we bill for an emergency department service when the physician, while wor... Read more
Pass Up Payment for Phone Advice
Question: Should we bill for an emergency department service when the physician, while wor... Read more
Reader Question:
Consider Work Done With Subsequent Care Codes
Question: Our emergency department physician answered a code blue to a patient's room, and... Read more
Consider Work Done With Subsequent Care Codes
Question: Our emergency department physician answered a code blue to a patient's room, and... Read more
Reader Question:
Report E/M for Repeat Drainage
Question: The emergency department physician had performed an incision and drainage proced... Read more
Report E/M for Repeat Drainage
Question: The emergency department physician had performed an incision and drainage proced... Read more
Reader Question:
Multiple Toes Call for Modifier -51
Question: If a patient has four fractured metatarsals on the same foot, should I report co... Read more
Multiple Toes Call for Modifier -51
Question: If a patient has four fractured metatarsals on the same foot, should I report co... Read more
Reader Question:
Make Your Points Count With EKGs
Question: Is it appropriate to bill for an electrocardiogram interpretation and also count... Read more
Make Your Points Count With EKGs
Question: Is it appropriate to bill for an electrocardiogram interpretation and also count... Read more
Reader Question:
Bill for Foley With Physician Supervision
Question: At our facility, we charge for Foley catheterization if the emergency department... Read more
Bill for Foley With Physician Supervision
Question: At our facility, we charge for Foley catheterization if the emergency department... Read more
Reader Question:
Append -52 for Extra Infusion Time
Question: What guidelines govern reporting a patient who receives less than two full hours... Read more
Append -52 for Extra Infusion Time
Question: What guidelines govern reporting a patient who receives less than two full hours... Read more
You Be the Coder:
Should You Report Fracture Care and E/M Services Together?
Question: If I report a code for definitive care of a fracture, does it include evaluation... Read more
Should You Report Fracture Care and E/M Services Together?
Question: If I report a code for definitive care of a fracture, does it include evaluation... Read more
Fight Observation Denials With Well-Aimed Documentation
Answer 'where, when, why and who' to nail down payment The rules for reporting observatio... Read more
Answer 'where, when, why and who' to nail down payment The rules for reporting observatio... Read more
Explosive Case Study:
Test Your Debridement Coding
See if you can handle the coding when a patient handles fire A simple accident can ... Read more
Test Your Debridement Coding
See if you can handle the coding when a patient handles fire A simple accident can ... Read more
Don't Leave Subsequent-Care Payment on the Table
Beef up paper trail to secure ED reimbursement For many ED physicians, the care the... Read more
Beef up paper trail to secure ED reimbursement For many ED physicians, the care the... Read more
How Can I Check Our 99231 Claims?
Random sample reveals patterns If your ED practice repeatedly reports the same subsequent... Read more
Random sample reveals patterns If your ED practice repeatedly reports the same subsequent... Read more
Signs, Symptoms, Diagnoses - Who's on First?
Find out what the experts say about what takes precedence After reading our article "Win ... Read more
Find out what the experts say about what takes precedence After reading our article "Win ... Read more
Reader Questions:
Consider Protocol Over Modifier -53
Question: A 4-year-old boy presented to the ED with a lacerated foot. The physician admini... Read more
Consider Protocol Over Modifier -53
Question: A 4-year-old boy presented to the ED with a lacerated foot. The physician admini... Read more
Reader Questions:
Say No to 'Past History Negative'
Question: When the physician writes "past history is negative," would this satisfy the "pa... Read more
Say No to 'Past History Negative'
Question: When the physician writes "past history is negative," would this satisfy the "pa... Read more
Reader Questions:
Include CPR in Critical Care
Question: A patient came to the ED, and the physician performed cardiopulmonary resuscitat... Read more
Include CPR in Critical Care
Question: A patient came to the ED, and the physician performed cardiopulmonary resuscitat... Read more
Reader Questions:
Back Up Use of MDM for 99285 Caveat
Question: Is there such thing as an acuity caveat for medical decision-making (MDM)? A pat... Read more
Back Up Use of MDM for 99285 Caveat
Question: Is there such thing as an acuity caveat for medical decision-making (MDM)? A pat... Read more
Reader Questions:
3 PFSH Items Unnecessary for Inpatient
Question: If the emergency department physician treats a patient and admits him, is it cor... Read more
3 PFSH Items Unnecessary for Inpatient
Question: If the emergency department physician treats a patient and admits him, is it cor... Read more
Reader Questions:
Don't Wait for X-Ray Results to Report Fractures
Question: When a patient with a fracture presents in the ED, our practice's current patter... Read more
Don't Wait for X-Ray Results to Report Fractures
Question: When a patient with a fracture presents in the ED, our practice's current patter... Read more
You Be the Coder:
Layers Don't Always Determine Repair Code
Question: We received the following documentation of a laceration repair: 3.5-cm lace... Read more
Layers Don't Always Determine Repair Code
Question: We received the following documentation of a laceration repair: 3.5-cm lace... Read more
Plug These Holes in Your Lumbar Puncture Coding
When the spinal tap's incomplete, make sure your coding isn'tIf you perform an unsuccessfu... Read more
When the spinal tap's incomplete, make sure your coding isn'tIf you perform an unsuccessfu... Read more
CASE STUDY:
Pick the Right E/M Code
Test your knowledge with this real-life scenario Think you know when to report a leve... Read more
Pick the Right E/M Code
Test your knowledge with this real-life scenario Think you know when to report a leve... Read more
Sharpen Your Fracture Care Vocabulary
Make sure you know these terms when the chart comes inIf you're not sure what part of the ... Read more
Make sure you know these terms when the chart comes inIf you're not sure what part of the ... Read more
Got the Wind Knocked Out of Your Asthma Diagnoses?
Ensure proper payment with these ICD-9 coding strategiesIf you don't need to rely on the p... Read more
Ensure proper payment with these ICD-9 coding strategiesIf you don't need to rely on the p... Read more
READER QUESTIONS:
Old Problems Are New in the ED
Question: Should we consider all patients who come through the emergency department to be ... Read more
Old Problems Are New in the ED
Question: Should we consider all patients who come through the emergency department to be ... Read more
READER QUESTIONS:
Report ICD-9 Only for Transferred Patient
Question: A patient presented to the emergency department with injuries from a motorcycle ... Read more
Report ICD-9 Only for Transferred Patient
Question: A patient presented to the emergency department with injuries from a motorcycle ... Read more
READER QUESTIONS:
Walk Softly With Modifiers and Critical Care
Question: What are the guidelines for modifier use with critical care codes? For example, ... Read more
Walk Softly With Modifiers and Critical Care
Question: What are the guidelines for modifier use with critical care codes? For example, ... Read more
READER QUESTIONS:
Talk to Carrier for Splint Check
Question: When an emergency department technician or a nurse applies a splint and then the... Read more
Talk to Carrier for Splint Check
Question: When an emergency department technician or a nurse applies a splint and then the... Read more
READER QUESTIONS:
Secure Proper Documentation for 99288
Question: What are the documentation requirements to report 99288? Is the documentation by... Read more
Secure Proper Documentation for 99288
Question: What are the documentation requirements to report 99288? Is the documentation by... Read more
READER QUESTIONS:
No Stars, No Suture Removals
Question: When should I bill for suture removal? When shouldn't I?Idaho Subscriber Answer... Read more
No Stars, No Suture Removals
Question: When should I bill for suture removal? When shouldn't I?Idaho Subscriber Answer... Read more
READER QUESTIONS:
Get Doctor's Review for History Elements
Question: Can we use nurses' notes to satisfy elements of ROS and PFSH, as long as the phy... Read more
Get Doctor's Review for History Elements
Question: Can we use nurses' notes to satisfy elements of ROS and PFSH, as long as the phy... Read more
READER QUESTIONS:
Examine Documentation for Asymptomatic Patient
Question: An asymptomatic patient presented to the ED needing a medication refill. Which E... Read more
Examine Documentation for Asymptomatic Patient
Question: An asymptomatic patient presented to the ED needing a medication refill. Which E... Read more
YOU BE THE CODER:
Think Twice About 'Incident-To' in the ED
Question: The ED physicians want me to charge for overseeing endotracheal and nasogastric ... Read more
Think Twice About 'Incident-To' in the ED
Question: The ED physicians want me to charge for overseeing endotracheal and nasogastric ... Read more
Don't Get Scorched by Faulty Burn Coding
Hint: Treatment calls for more than the 16000 codes The treatment your physician provides... Read more
Hint: Treatment calls for more than the 16000 codes The treatment your physician provides... Read more
Cut Denials With New Decubitus Ulcer Diagnoses
New ICD-9 codes make multiple bedsore description easier Heads up, ED coders: Don't just ... Read more
New ICD-9 codes make multiple bedsore description easier Heads up, ED coders: Don't just ... Read more
Weigh Your Options With After-Hours Codes
Compensation may come with a price A patient with a high fever and vomiting presents to t... Read more
Compensation may come with a price A patient with a high fever and vomiting presents to t... Read more
Pose 1 Crucial Question to Negotiate -52 and -53
How to pick the correct modifier for incomplete procedures When your physician stops in t... Read more
How to pick the correct modifier for incomplete procedures When your physician stops in t... Read more
Watch for These New Diagnosis Codes
Come Oct. 1, you won't have time to fumble with new codes in the emergency department -- s... Read more
Come Oct. 1, you won't have time to fumble with new codes in the emergency department -- s... Read more
Reqder Question:
Usually Report Closed Treatment in ED
Question: What does "closed treatment" mean in the case of a rib fracture? The standard ... Read more
Usually Report Closed Treatment in ED
Question: What does "closed treatment" mean in the case of a rib fracture? The standard ... Read more
Reader Question:
Identify Cause of Fall for E Code
Question: Is it appropriate to report a syncope and collapse code with E codes for a pat... Read more
Identify Cause of Fall for E Code
Question: Is it appropriate to report a syncope and collapse code with E codes for a pat... Read more
Reader Question:
Determine Payer for Follow-Up Charge
Question: The ED physician performed an incision and drainage procedure on a patient two... Read more
Determine Payer for Follow-Up Charge
Question: The ED physician performed an incision and drainage procedure on a patient two... Read more
Reader Question:
Walk Softly When Billing 2 Tests
Question: I've heard that in order to bill both an EKG and rhythm strip in the same visi... Read more
Walk Softly When Billing 2 Tests
Question: I've heard that in order to bill both an EKG and rhythm strip in the same visi... Read more
Reader Question:
Distinguish Between Infusion and Injection
Question: What is the difference between codes 90780 and 90784? Which one is more approp... Read more
Distinguish Between Infusion and Injection
Question: What is the difference between codes 90780 and 90784? Which one is more approp... Read more
Reader Question:
Fine Line Between Reduction and Manipulation
Question: When reporting fracture care, what's the difference between reduction and mani... Read more
Fine Line Between Reduction and Manipulation
Question: When reporting fracture care, what's the difference between reduction and mani... Read more
Reader Question:
Forgo -57 for Patients Headed Directly to OR
Question: When should I use modifier -57 (Decision for surgery)? Does this modifier appl... Read more
Forgo -57 for Patients Headed Directly to OR
Question: When should I use modifier -57 (Decision for surgery)? Does this modifier appl... Read more
You Be The Coder:
Difficulty Determines Laceration Code
Question: A patient came in with a laceration of the finger and nail bed. The physician ... Read more
Difficulty Determines Laceration Code
Question: A patient came in with a laceration of the finger and nail bed. The physician ... Read more
Anesthesia Coding Knocking You Out?
Hit the ground running with these do's and don'ts on anesthesia billing in the ED If you'... Read more
Hit the ground running with these do's and don'ts on anesthesia billing in the ED If you'... Read more
Bone Up on Diagnosis Coding for Acute Chest Syndrome
Signs-and-symptoms coding holds key to solid claims If your ED physician diagnoses a sick... Read more
Signs-and-symptoms coding holds key to solid claims If your ED physician diagnoses a sick... Read more
Sickle-Cell Codes to Keep in Mind
When reporting services related to acute chest syndrome (ACS), refer to this quick list fo... Read more
When reporting services related to acute chest syndrome (ACS), refer to this quick list fo... Read more
News You Can Use:
CMS Offers No Breathing Room With ICD-9/HCPCS Transition
Elimination of grace period boxes you in to Oct.1 Set your calendars, practices: CMS isn... Read more
CMS Offers No Breathing Room With ICD-9/HCPCS Transition
Elimination of grace period boxes you in to Oct.1 Set your calendars, practices: CMS isn... Read more
6 Surefire Tips to Get Your Cerumen Removal Claims Paid
Why you'll get denied if you report 69210 more than once per episode With numerous CPT an... Read more
Why you'll get denied if you report 69210 more than once per episode With numerous CPT an... Read more
News You Can Use:
Who Will Speak for Your Practice In the EMTALA Advisory Group?
CMS wants viewpoints from patient advocates, hospitals and physicians You could have a h... Read more
Who Will Speak for Your Practice In the EMTALA Advisory Group?
CMS wants viewpoints from patient advocates, hospitals and physicians You could have a h... Read more
Reader Question:
Coding Interpretation of X-Rays
Question: How should I report a scenario in which the physician did not take x-rays but ... Read more
Coding Interpretation of X-Rays
Question: How should I report a scenario in which the physician did not take x-rays but ... Read more
Reader Question:
Consider Added MDM for Young Patients
Question: A 9-month-old child with eyes swollen shut presents to the emergency department.... Read more
Consider Added MDM for Young Patients
Question: A 9-month-old child with eyes swollen shut presents to the emergency department.... Read more
Reader Question:
Check Place and State for Tumor Code
Question: The physician excised a 2.7-centimeter tumor on a 34-year-old male outpatient.... Read more
Check Place and State for Tumor Code
Question: The physician excised a 2.7-centimeter tumor on a 34-year-old male outpatient.... Read more
Reader Question:
Count Places, Not People, for ED Services
Question: How should I handle services rendered in the emergency department by non-emerg... Read more
Count Places, Not People, for ED Services
Question: How should I handle services rendered in the emergency department by non-emerg... Read more
Reader Question:
John Hancock Might Not Cut It for EKGs
Question: Our doctors are under the impression that since our electrocardiogram (EKG) ma... Read more
John Hancock Might Not Cut It for EKGs
Question: Our doctors are under the impression that since our electrocardiogram (EKG) ma... Read more
Reader Question:
Stick Your Neck Out for Correct ROS Choice
Question: Our doctors use the phrase "Neck is supple" all the time in their documentatio... Read more
Stick Your Neck Out for Correct ROS Choice
Question: Our doctors use the phrase "Neck is supple" all the time in their documentatio... Read more
Reader Question:
Don't Let 2nd Service Wrap Into Global Care
Question: I received a denial from Medicare for a patient who had two hip dislocation re... Read more
Don't Let 2nd Service Wrap Into Global Care
Question: I received a denial from Medicare for a patient who had two hip dislocation re... Read more
Reader Question:
Report E/M Code for Ear Wick
Question: What is the correct code for an ear-wick insertion? Oklahoma Subscriber Answ... Read more
Report E/M Code for Ear Wick
Question: What is the correct code for an ear-wick insertion? Oklahoma Subscriber Answ... Read more
You Be the Coder:
What Counts as an Incision?
Question: The physician removed an embedded fish hook by cutting the barb with wire cutt... Read more
What Counts as an Incision?
Question: The physician removed an embedded fish hook by cutting the barb with wire cutt... Read more
Employ Modifiers -59 and -51 to Separate Related Codes
Modifier -59 is for procedures that are not reported together in most cases When a physic... Read more
Modifier -59 is for procedures that are not reported together in most cases When a physic... Read more
Check CPT for Modifier -51 Exemptions
'Circle with a slash' sign indicates modifier -51 exempt code Think you're... Read more
'Circle with a slash' sign indicates modifier -51 exempt code Think you're... Read more
2 Tips Help You Correctly Use Modifier -59
Modifier is not needed when the doctor treats different sites When you file claims with m... Read more
Modifier is not needed when the doctor treats different sites When you file claims with m... Read more
Wrong Injection Type, Infusion Code Can Shoot Down Claim
Medicare has its own codes for infusion sessions When the physician performs an injection... Read more
Medicare has its own codes for infusion sessions When the physician performs an injection... Read more
4 Rules to Remember:
Infusion Coding Do's and Don'ts
Remember: Chemo has its own set of codes When reporting infusion codes, make sure you kee... Read more
Infusion Coding Do's and Don'ts
Remember: Chemo has its own set of codes When reporting infusion codes, make sure you kee... Read more
Reader Question:
Use Add-On Codes for Biopsies, Not Brushings
Question: Can I bill for multiple bronchoscopy brushings and biopsies when the ED physicia... Read more
Use Add-On Codes for Biopsies, Not Brushings
Question: Can I bill for multiple bronchoscopy brushings and biopsies when the ED physicia... Read more
Reader Question:
Check Payer Policy When Billing 99288
Question: Recently Medicare denied our claim for emergency care code 99288. This was our f... Read more
Check Payer Policy When Billing 99288
Question: Recently Medicare denied our claim for emergency care code 99288. This was our f... Read more
Reader Question:
Document Results When Filing Portable
Question: Our ED physician has begun using a portable echocardiograph machine. How should ... Read more
Document Results When Filing Portable
Question: Our ED physician has begun using a portable echocardiograph machine. How should ... Read more
Reader Question:
Physician Involvement Can Add E/M Code to Injection Claim
Question: When the physician performs an intramuscular injection, are there any situations... Read more
Physician Involvement Can Add E/M Code to Injection Claim
Question: When the physician performs an intramuscular injection, are there any situations... Read more
Reader Question:
Eye Burn Treatment Doesn't Have to Be Painful
Question: A patient reported to the emergency department with a burn to his left eyelid af... Read more
Eye Burn Treatment Doesn't Have to Be Painful
Question: A patient reported to the emergency department with a burn to his left eyelid af... Read more
Reader Question:
Document Distinct Sessions on Multiple CPR Claims
Question: One of our ED physicians spent critical care time with an inpatient on two separ... Read more
Document Distinct Sessions on Multiple CPR Claims
Question: One of our ED physicians spent critical care time with an inpatient on two separ... Read more
You Be The Coder:
Get a Grip on Discontinued Lumbar Punctures
Question: During a lumbar puncture, the patient's left leg became numb, and he had severe ... Read more
Get a Grip on Discontinued Lumbar Punctures
Question: During a lumbar puncture, the patient's left leg became numb, and he had severe ... Read more
Patch Up Holes in Your Laceration Coding
These 3 rules can save you $50 per cut Reimbursement for laceration repairs could be slip... Read more
These 3 rules can save you $50 per cut Reimbursement for laceration repairs could be slip... Read more
See Through Chest X-Ray Troubles
Follow these tips to 'x' out denials Your emergency department (ED) performs chest x-rays... Read more
Follow these tips to 'x' out denials Your emergency department (ED) performs chest x-rays... Read more
Test Your Laceration Coding Know-How
Determine how you would code these laceration repairs If you're still unsure about... Read more
Determine how you would code these laceration repairs If you're still unsure about... Read more
Watch for 5 Complications When Coding Diabetes
Don't get tripped up on multiple conditions Each time you choose a fourth and fifth digit... Read more
Don't get tripped up on multiple conditions Each time you choose a fourth and fifth digit... Read more
Reader Question:
How to Report Cerumen Removal
Question: How should I report cerumen removal, and can I ever report a separate evaluation... Read more
How to Report Cerumen Removal
Question: How should I report cerumen removal, and can I ever report a separate evaluation... Read more
Reader Question:
Attach -GY, -GZ to Speed Denials
Question: What are modifiers -GY and -GZ, and how should I use them? Oreg... Read more
Attach -GY, -GZ to Speed Denials
Question: What are modifiers -GY and -GZ, and how should I use them? Oreg... Read more
Reader Question:
Use Modifier -24 for Unrelated E/M
Question: A patient reported to the emergency department three weeks ago for pain in his r... Read more
Use Modifier -24 for Unrelated E/M
Question: A patient reported to the emergency department three weeks ago for pain in his r... Read more
Reader Question:
Cover Your Bases With Poisoning
Question: A patient who had apparently attempted suicide by ingesting multiple medications... Read more
Cover Your Bases With Poisoning
Question: A patient who had apparently attempted suicide by ingesting multiple medications... Read more
Reader Question:
Report ED E/M for Help With Delivery
Question: How should I report a scenario in which the emergency department physician helps... Read more
Report ED E/M for Help With Delivery
Question: How should I report a scenario in which the emergency department physician helps... Read more
You Be The Coder:
Report Layer Closure Separately
Question: Our physician saw a patient with lesions on his face and cheek. He excised a 2.6... Read more
Report Layer Closure Separately
Question: Our physician saw a patient with lesions on his face and cheek. He excised a 2.6... Read more
Don't Infect Your Claims With Sepsis Coding Errors
Diagnosis coding success eliminates mistakesIf you're mixed up about which codes to report... Read more
Diagnosis coding success eliminates mistakesIf you're mixed up about which codes to report... Read more
Your Quick Guide to Sepsis Vocabulary
Sepsis-related terms making your head spin? Refer to this list when you need a little extr... Read more
Sepsis-related terms making your head spin? Refer to this list when you need a little extr... Read more
Think You Know How to Use Modifier -25?
Answer 3 questions to tell for sureIf you want to recoup reimbursement for your modifier -... Read more
Answer 3 questions to tell for sureIf you want to recoup reimbursement for your modifier -... Read more
Reader Question:
Consult Hospital Policy for ABN
Question: We have a patient who comes to the ED to receive Procrit injections. His diagnos... Read more
Consult Hospital Policy for ABN
Question: We have a patient who comes to the ED to receive Procrit injections. His diagnos... Read more
Reader Question:
Treat Mother and Baby as Individuals
Question: If a baby is born in the emergency department, and the ED physician examines the... Read more
Treat Mother and Baby as Individuals
Question: If a baby is born in the emergency department, and the ED physician examines the... Read more
Reader Question:
Don't List Confusing Diagnostic Information
Question: A patient presents to the emergency department with a complaint of chest pain. T... Read more
Don't List Confusing Diagnostic Information
Question: A patient presents to the emergency department with a complaint of chest pain. T... Read more
Reader Question:
Examine Physician Work for Rabies Shot E/M
Question: A patient presented to the emergency department for a second shot in a series of... Read more
Examine Physician Work for Rabies Shot E/M
Question: A patient presented to the emergency department for a second shot in a series of... Read more
Reader Question:
Check Carrier for Splinting Services
Question: If the physician supervises the nurse as she applies a splint, can I charge a pr... Read more
Check Carrier for Splinting Services
Question: If the physician supervises the nurse as she applies a splint, can I charge a pr... Read more
Reader Question:
Ponder Alternatives to 52310
Question: The physician palpated the patient's flaccid penis, and found a hard area in the... Read more
Ponder Alternatives to 52310
Question: The physician palpated the patient's flaccid penis, and found a hard area in the... Read more
Reader Question - Tread Lightly:
Depression and Critical Care
Question: Can I report a critical care code when the diagnosis is a mental illness, such a... Read more
Depression and Critical Care
Question: Can I report a critical care code when the diagnosis is a mental illness, such a... Read more
You Be The Coder:
Home In on MDM for Abdominal Pain
Question: A 22-year-old patient came into the emergency room with abdominal pain and vomit... Read more
Home In on MDM for Abdominal Pain
Question: A 22-year-old patient came into the emergency room with abdominal pain and vomit... Read more
Fracture Care Denials Breaking Your Bank?
Heal your reimbursement with these strategiesIf you're having trouble picking fracture and... Read more
Heal your reimbursement with these strategiesIf you're having trouble picking fracture and... Read more
Win the Battle:
Diagnoses Versus Signs and Symptoms
When reporting each is appropriateYou've heard the story both ways: Some coders say report... Read more
Diagnoses Versus Signs and Symptoms
When reporting each is appropriateYou've heard the story both ways: Some coders say report... Read more
Reader Question:
Code EKG and Critical Care Together
Question: Can I report electrocardiogram (EKG) interpretation in addition to critical care... Read more
Code EKG and Critical Care Together
Question: Can I report electrocardiogram (EKG) interpretation in addition to critical care... Read more
Reader Question:
Use Anesthesia Code for Sedative Help
Question: Our physician frequently sedates patients with fractures that the orthopedic res... Read more
Use Anesthesia Code for Sedative Help
Question: Our physician frequently sedates patients with fractures that the orthopedic res... Read more
Reader Question:
Look Carefully for Observation Services
Question: Many of our patients receive intravenous fluids for four to six hours in the eme... Read more
Look Carefully for Observation Services
Question: Many of our patients receive intravenous fluids for four to six hours in the eme... Read more
Reader Question:
Be Flexible With 59409
Question: A patient presented in the emergency department, and the physician discovered th... Read more
Be Flexible With 59409
Question: A patient presented in the emergency department, and the physician discovered th... Read more
Reader Question:
Consider Tube Placement When Reporting LMA
Question: Another hospital brought a woman in respiratory failure to our emergency departm... Read more
Consider Tube Placement When Reporting LMA
Question: Another hospital brought a woman in respiratory failure to our emergency departm... Read more
Reader Question:
Take Credit for Inpatient Care
Question: Should I bill for services that our ED physician provides to an inpatient? For e... Read more
Take Credit for Inpatient Care
Question: Should I bill for services that our ED physician provides to an inpatient? For e... Read more
You Be The Coder:
Should I Report an E/M for Code Blue?
Question: The emergency department (ED) physician receives a call to the floor for a code ... Read more
Should I Report an E/M for Code Blue?
Question: The emergency department (ED) physician receives a call to the floor for a code ... Read more
Use Tunnel Vision for Venous Access Codes
Focus on central lines to avoid CPT 2004 confusion The slew of new CPT codes for venous a... Read more
Focus on central lines to avoid CPT 2004 confusion The slew of new CPT codes for venous a... Read more
Don't Fail the Test on Teaching Physician Rules
Learn to bill correctly when doctors - and med students - work together If you want to ge... Read more
Learn to bill correctly when doctors - and med students - work together If you want to ge... Read more
Get a Grip on Medical Notes for Teaching Physician Rules
Use these expert tips for surefire documentation Knowing how and when to report evaluatio... Read more
Use these expert tips for surefire documentation Knowing how and when to report evaluatio... Read more
Inspect Documentation for Clues to MDM
Decision-making isn't based on the diagnosis alone Every patient with a head injury doesn... Read more
Decision-making isn't based on the diagnosis alone Every patient with a head injury doesn... Read more
Breathe a Sigh of Relief With EMTALA Mandate
Emergency care for illegal immigrants doesn't have to be a total loss If you're sick ... Read more
Emergency care for illegal immigrants doesn't have to be a total loss If you're sick ... Read more
Identify Missing Medical Decision-Making Components
2 sample charts tell you when you need to get more information Check out the differences... Read more
2 sample charts tell you when you need to get more information Check out the differences... Read more
Reader Question:
Count Global Days With Modifiers
Question: As far as I understand, modifier -57 is appropriate when a physician makes a dec... Read more
Count Global Days With Modifiers
Question: As far as I understand, modifier -57 is appropriate when a physician makes a dec... Read more
Reader Question:
Report Anesthesia When Patient's On the Table
Question: Do code descriptions that include the phrase "requiring anesthesia" refer only t... Read more
Report Anesthesia When Patient's On the Table
Question: Do code descriptions that include the phrase "requiring anesthesia" refer only t... Read more
Reader Question:
Don't Confuse Open Fracture With Open Treatment
Question: What constitutes an open fracture, and what does its care include? &n... Read more
Don't Confuse Open Fracture With Open Treatment
Question: What constitutes an open fracture, and what does its care include? &n... Read more
You Be the Coder:
Watch Modifiers With Fracture Treatment
Question: Our ED physician reported evaluation and management code 99283-25 and 26720-54 f... Read more
Watch Modifiers With Fracture Treatment
Question: Our ED physician reported evaluation and management code 99283-25 and 26720-54 f... Read more
Don't Let Starless Codes Deter Separately Reporting an E/M
Eliminated starred procedure concept docks payment The whole will no longer equal the sum... Read more
Eliminated starred procedure concept docks payment The whole will no longer equal the sum... Read more
3 Tips to Hard-Earned Ultrasound Cash
Billing when the odds are against you Many emergency department physicians and coders don... Read more
Billing when the odds are against you Many emergency department physicians and coders don... Read more
Keep ECG Diagnosis Coding On Target With 3 Steps
Specificity and razor-sharp record keeping hold the key Emergency department physicians p... Read more
Specificity and razor-sharp record keeping hold the key Emergency department physicians p... Read more
Reader Question:
Choose Between G Code and 12000 for Laceration
Question: An elderly patient presented in our ED with a half-circle skin tear on his forea... Read more
Choose Between G Code and 12000 for Laceration
Question: An elderly patient presented in our ED with a half-circle skin tear on his forea... Read more
Reader Question:
Revamp Fee Schedule at Your Leisure
Question: Can we update and increase our Fee Schedule at any time, or do we have to do it ... Read more
Revamp Fee Schedule at Your Leisure
Question: Can we update and increase our Fee Schedule at any time, or do we have to do it ... Read more
Reader Question:
Medicare Won't Pay for Adverse Reactions
Question: A patient presented in the ED with a laceration on her leg, which the physician ... Read more
Medicare Won't Pay for Adverse Reactions
Question: A patient presented in the ED with a laceration on her leg, which the physician ... Read more
Reader Question:
Know Who Did What for Fracture Treatment
Question: A patient presented with a fracture of the ankle. It was severe enough to compro... Read more
Know Who Did What for Fracture Treatment
Question: A patient presented with a fracture of the ankle. It was severe enough to compro... Read more
You Be the Coder:
How Risky Are Tetanus Shots?
Question: We had a patient present to the ED for a tetanus shot. Another physician had alr... Read more
How Risky Are Tetanus Shots?
Question: We had a patient present to the ED for a tetanus shot. Another physician had alr... Read more