ED Coding and Reimbursement Alert
Check Target for Separate Sedation Coding In 2006
New codes for sedation and late-night care lighten your reporting burdenIf you-ve been con... Read more
New codes for sedation and late-night care lighten your reporting burdenIf you-ve been con... Read more
Meet Your New Time-Sensitive Moderate Sedation Codes
Age differences and add-on codes hit the scene in 2006Out with the old, in with the new: S... Read more
Age differences and add-on codes hit the scene in 2006Out with the old, in with the new: S... Read more
New Moderate Sedation Codes for 2006
- 99143--Moderate sedation services (other than those services described by co... Read more
- 99143--Moderate sedation services (other than those services described by co... Read more
Not Enough Beds? How to Handle ED Boarders
Use this method to earn inpatient pay for inpatient servicesJust because all inpatient bed... Read more
Use this method to earn inpatient pay for inpatient servicesJust because all inpatient bed... Read more
Plan Your 2006 Budget With Care
Medicare payments may dwindle come JanuaryExpect your Medicare payments to shrink in 2006,... Read more
Medicare payments may dwindle come JanuaryExpect your Medicare payments to shrink in 2006,... Read more
READER QUESTIONS:
Dislocation Earns More Than E/M
Question: A patient recently presented in the ED with a dislocated shoulder. The ED physic... Read more
Dislocation Earns More Than E/M
Question: A patient recently presented in the ED with a dislocated shoulder. The ED physic... Read more
READER QUESTIONS:
Don't Slight Your X-Ray Reimbursement
Question: Can we bill for concurrent radiology interpretations? Illinois Subscriber Answe... Read more
Don't Slight Your X-Ray Reimbursement
Question: Can we bill for concurrent radiology interpretations? Illinois Subscriber Answe... Read more
READER QUESTIONS:
Use 1200x for Ulnar Artery
Question: A patient presents to the ED with a laceration involving the ulnar artery and ul... Read more
Use 1200x for Ulnar Artery
Question: A patient presents to the ED with a laceration involving the ulnar artery and ul... Read more
READER QUESTIONS:
Bill Only for Your Staff
Question: Is it appropriate for us to bill for services that hospital staff (such as nurse... Read more
Bill Only for Your Staff
Question: Is it appropriate for us to bill for services that hospital staff (such as nurse... Read more
READER QUESTIONS:
Examine Cause for AICD Code
Question: An older male patient presented in the ED complaining that his automatic defibri... Read more
Examine Cause for AICD Code
Question: An older male patient presented in the ED complaining that his automatic defibri... Read more
READER QUESTIONS:
Back Up US Code With Report
Question: What documentation is required to bill ultrasounds that the ED physician perform... Read more
Back Up US Code With Report
Question: What documentation is required to bill ultrasounds that the ED physician perform... Read more
READER QUESTIONS:
Need Documentation for Shared Encounter
Question: I understand that we can bill for shared encounters (between the ED physician an... Read more
Need Documentation for Shared Encounter
Question: I understand that we can bill for shared encounters (between the ED physician an... Read more
READER QUESTIONS:
Report E/M for Tracheostomy
Question: What is the procedure code for a tracheostomy replacement with a Shiley-6 tube? ... Read more
Report E/M for Tracheostomy
Question: What is the procedure code for a tracheostomy replacement with a Shiley-6 tube? ... Read more
READER QUESTIONS:
Understand Definitive Care for 21800
Question: The ED physician ordered an x-ray for a patient that revealed broken ribs. He ga... Read more
Understand Definitive Care for 21800
Question: The ED physician ordered an x-ray for a patient that revealed broken ribs. He ga... Read more
You Be the Coder:
Location Matters for the Guaiac Test
Question: Can we bill for the guaiac test?Texas SubscriberAnswer: You may be able to... Read more
Location Matters for the Guaiac Test
Question: Can we bill for the guaiac test?Texas SubscriberAnswer: You may be able to... Read more
Tighten Up Your Fracture Treatment Coding
Solve these case studies to report casting with confidenceThe difference between definitiv... Read more
Solve these case studies to report casting with confidenceThe difference between definitiv... Read more
Know When to Cut Your Cut of Reimbursement
How to make smart decisions about appropriate modifier 52 useAppending modifier 52 can sig... Read more
How to make smart decisions about appropriate modifier 52 useAppending modifier 52 can sig... Read more
Important Terminology:
Fracture Care Tips You Need To Remember
Prepare on-target claims by having all the right infoDon't send your fracture treatment cl... Read more
Fracture Care Tips You Need To Remember
Prepare on-target claims by having all the right infoDon't send your fracture treatment cl... Read more
READER QUESTIONS:
Select Carefully for Delivery Assistance
Question: One of our physicians was called to the floor because a patient was giving birth... Read more
Select Carefully for Delivery Assistance
Question: One of our physicians was called to the floor because a patient was giving birth... Read more
READER QUESTIONS:
Try E-Charts for Quicker Coding
Question: What is the recommended cap for the time lapse between an ED encounter and the d... Read more
Try E-Charts for Quicker Coding
Question: What is the recommended cap for the time lapse between an ED encounter and the d... Read more
READER QUESTIONS:
Consult Policy for Imcomplete Reduction
Question: A patient presented in the ED with a fracture of the tibia involving the medial ... Read more
Consult Policy for Imcomplete Reduction
Question: A patient presented in the ED with a fracture of the tibia involving the medial ... Read more
READER QUESTIONS:
Extra Cleaning Earns Intermediate Repair
Question: The ED physician removed extensive debris from a wound that then required a sing... Read more
Extra Cleaning Earns Intermediate Repair
Question: The ED physician removed extensive debris from a wound that then required a sing... Read more
READER QUESTIONS:
Report High-Level E/M for Status Asthmaticus
Question: Should I code documentation that states -acute status asthmaticus- as status ast... Read more
Report High-Level E/M for Status Asthmaticus
Question: Should I code documentation that states -acute status asthmaticus- as status ast... Read more
READER QUESTIONS:
Check NCCI Edits for Infusion Rules
Question: Can we report both IV access and infusion in the same ED encounter, or is that u... Read more
Check NCCI Edits for Infusion Rules
Question: Can we report both IV access and infusion in the same ED encounter, or is that u... Read more
READER QUESTIONS:
Add Diagnosis for E Code
Question: A patient presented in the ED complaining of pain in his shoulder after a basket... Read more
Add Diagnosis for E Code
Question: A patient presented in the ED complaining of pain in his shoulder after a basket... Read more
You Be the Coder:
Can You Report EMS Direction?
Question: When our physicians give EMS online medical direction, can we bill for it?Kentuc... Read more
Can You Report EMS Direction?
Question: When our physicians give EMS online medical direction, can we bill for it?Kentuc... Read more
3 Steps to Beat Burn Diagnosis Coding
Accurate codes tell exact location and severity When a patient with a burn shows up in t... Read more
Accurate codes tell exact location and severity When a patient with a burn shows up in t... Read more
Score Needed Documentation For Critical Care Codes
Know what to ask the doctor for improved 99291 claims Coming up short when coding for... Read more
Know what to ask the doctor for improved 99291 claims Coming up short when coding for... Read more
Don't Infect Your Claims With Sepsis Coding Errors
Diagnosis coding success eliminates mistakes If you're mixed up about which codes to repo... Read more
Diagnosis coding success eliminates mistakes If you're mixed up about which codes to repo... Read more
Handy Guide to Sepsis Terms
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
Reader Questions:
Nix 90782 in ED
Question: When the physician sees the patient for an injury in the ED, is it appropriate t... Read more
Nix 90782 in ED
Question: When the physician sees the patient for an injury in the ED, is it appropriate t... Read more
Reader Questions:
Separate E/M and Observation
Question: I've heard that ED physicians cannot charge for both an ED E/M and observation s... Read more
Separate E/M and Observation
Question: I've heard that ED physicians cannot charge for both an ED E/M and observation s... Read more
Reader Questions:
Use Time Wisely for Query
Question: For a patient who recently presented to the ED with GI bleeding and anemia, the ... Read more
Use Time Wisely for Query
Question: For a patient who recently presented to the ED with GI bleeding and anemia, the ... Read more
Reader Questions:
Exclude Allergies Statement From ROS
Question: An 18-year-old patient with a possible broken finger after hitting a wall with h... Read more
Exclude Allergies Statement From ROS
Question: An 18-year-old patient with a possible broken finger after hitting a wall with h... Read more
Reader Questions:
Count Diaphoresis as Integumentary
Question: When breaking down the ROS elements, in what system should we categorize diaphor... Read more
Count Diaphoresis as Integumentary
Question: When breaking down the ROS elements, in what system should we categorize diaphor... Read more
You Be the Coder:
Check Insert Site for PICC Code
Question: A patient presented in the ED and the physician placed a PICC line. A week later... Read more
Check Insert Site for PICC Code
Question: A patient presented in the ED and the physician placed a PICC line. A week later... Read more
Secure E/M Before Billing for Conscious Sedation
Make sure your doctor isn't doing someone else's dirty work--for free Because emergency p... Read more
Make sure your doctor isn't doing someone else's dirty work--for free Because emergency p... Read more
If the Doctor Says 'Stroke,' You Can List 434.91
But double-check whether the patient had a hemorrhage Just because you can list 434.9... Read more
But double-check whether the patient had a hemorrhage Just because you can list 434.9... Read more
5 Answers to Your Most Pressing X-Ray Questions
See through your problem claims with these expert tipsIf you can't get a handle on coding ... Read more
See through your problem claims with these expert tipsIf you can't get a handle on coding ... Read more
REDAER QUESTIONS:
Use E/M for Spontaneous Abortion
Question: The patient presented to the ED with abdominal pain and vaginal bleeding. The pa... Read more
Use E/M for Spontaneous Abortion
Question: The patient presented to the ED with abdominal pain and vaginal bleeding. The pa... Read more
READER QUESTIONS:
No 'Incident-To' in ED
Question: If nurse practitioners (NPs) are employed by the emergency physician group rathe... Read more
No 'Incident-To' in ED
Question: If nurse practitioners (NPs) are employed by the emergency physician group rathe... Read more
READER QUESTIONS:
Consider 99291 for RSI Patient
Question: When the ED physician performs rapid sequence induction (RSI) prior to an endotr... Read more
Consider 99291 for RSI Patient
Question: When the ED physician performs rapid sequence induction (RSI) prior to an endotr... Read more
READER QUESTIONS:
Try 20103 for BB Removal
Question: A patient presented in the ED with a BB lodged in his hand. The physician made a... Read more
Try 20103 for BB Removal
Question: A patient presented in the ED with a BB lodged in his hand. The physician made a... Read more
READER QUESTIONS:
Evaluate Circumstances for Death Note
Question: How should I submit a charge for the physician's death pronouncement (or death n... Read more
Evaluate Circumstances for Death Note
Question: How should I submit a charge for the physician's death pronouncement (or death n... Read more
READER QUESTIONS:
Report Critical Care for Code Blue
Question: If the ED physician responds to an inpatient code blue and performs critical car... Read more
Report Critical Care for Code Blue
Question: If the ED physician responds to an inpatient code blue and performs critical car... Read more
READER QUESTIONS:
Use 'All Others Negative' Wisely
Question: Our practice uses a template that includes a check box designated -All other sys... Read more
Use 'All Others Negative' Wisely
Question: Our practice uses a template that includes a check box designated -All other sys... Read more
You Be the Coder:
Draw the Line Between 99285 and 99291
Question: A patient presented to the ED with shortness of breath and chest pain that had s... Read more
Draw the Line Between 99285 and 99291
Question: A patient presented to the ED with shortness of breath and chest pain that had s... Read more
Don't Skimp on Multiple-Day Observation Care
Nail timing, proper notes for deserved reimbursement Observation care can require a great... Read more
Nail timing, proper notes for deserved reimbursement Observation care can require a great... Read more
Clear 5th-Digit DM Obstacles With These Rules of Thumb
Pathology, complications, and control unlock diagnoses As research continues to rev... Read more
Pathology, complications, and control unlock diagnoses As research continues to rev... Read more
Check Your Charts:
Observation Coding Do's and Don'ts
Find flaws before you drop the claim - and keep your reimbursement intact If the de... Read more
Observation Coding Do's and Don'ts
Find flaws before you drop the claim - and keep your reimbursement intact If the de... Read more
Reader Questions:
Avoid 99293 for ED Care
Question: The parents of a 6-month-old girl brought her into the ED after she nearly drown... Read more
Avoid 99293 for ED Care
Question: The parents of a 6-month-old girl brought her into the ED after she nearly drown... Read more
Reader Questions:
Save Digital Block for Pain
Question: When is it appropriate to report a digital block? Is it always bundled?Delaware ... Read more
Save Digital Block for Pain
Question: When is it appropriate to report a digital block? Is it always bundled?Delaware ... Read more
Reader Questions:
Skip LT, RT for Pelvis X-Ray
Question: The ED physician interpreted x-rays of both the right and left sides of a patien... Read more
Skip LT, RT for Pelvis X-Ray
Question: The ED physician interpreted x-rays of both the right and left sides of a patien... Read more
Reader Questions:
Report Strapping for Jones
Question: Should I consider a Jones dressing a splint or a strap for coding purposes? It d... Read more
Report Strapping for Jones
Question: Should I consider a Jones dressing a splint or a strap for coding purposes? It d... Read more
Reader Questions:
Obtain Doctor's Findings for UA
Question: When we code a urinalysis (UA), the lab template says, "culture if indicated." W... Read more
Obtain Doctor's Findings for UA
Question: When we code a urinalysis (UA), the lab template says, "culture if indicated." W... Read more
Reader Questions:
Let 11044 Trump Amputation Code
Question: A patient presented with a partial traumatic amputation of his distal fingerti... Read more
Let 11044 Trump Amputation Code
Question: A patient presented with a partial traumatic amputation of his distal fingerti... Read more
Reader Questions:
Require Physician Statement for CC
Question: A very dramatic patient presented to the ED with intense stomach pain, diaphores... Read more
Require Physician Statement for CC
Question: A very dramatic patient presented to the ED with intense stomach pain, diaphores... Read more
Reader Questions:
Ask for Specificity From TP
Question: What should I look for in the documentation to make sure the teaching physician ... Read more
Ask for Specificity From TP
Question: What should I look for in the documentation to make sure the teaching physician ... Read more
You Be the Coder:
Choose Burn Codes Carefully
Question: When coding for the professional side, when should I report burn codes? At our h... Read more
Choose Burn Codes Carefully
Question: When coding for the professional side, when should I report burn codes? At our h... Read more
Take the 2-for-1 Special With HPI and ROS Elements
You can use the same element for both - for some carriers The physician has left you copi... Read more
You can use the same element for both - for some carriers The physician has left you copi... Read more
Find Out How to Report Heart-Related ED Care
Your MI, EKG, cardioversion questions answered In the emergency department, the physician... Read more
Your MI, EKG, cardioversion questions answered In the emergency department, the physician... Read more
News Brief:
Get Special Payments for Treating Undocumented Aliens
Congress has $250 million set aside to pay for your services You can receive direct... Read more
Get Special Payments for Treating Undocumented Aliens
Congress has $250 million set aside to pay for your services You can receive direct... Read more
News Brief:
ACEP President Sounds Alarm On Overcrowded EDs
Record ED numbers may only be starting, Suter says The president of the leading emergency... Read more
ACEP President Sounds Alarm On Overcrowded EDs
Record ED numbers may only be starting, Suter says The president of the leading emergency... Read more
Reader Questions:
Report 90784 for ED Injections
Question: When ED physicians order antibiotics, cardiac drugs, Benadryl for allergic react... Read more
Report 90784 for ED Injections
Question: When ED physicians order antibiotics, cardiac drugs, Benadryl for allergic react... Read more
Reader Questions:
Check Dates for 'Dead' Patient
Question: We recently received a denial from Medicare for an emergency department visit be... Read more
Check Dates for 'Dead' Patient
Question: We recently received a denial from Medicare for an emergency department visit be... Read more
Reader Questions:
Subtract CPR Time With 99291
Question: Can we charge for CPR and critical care in the same encounter? I don't think Med... Read more
Subtract CPR Time With 99291
Question: Can we charge for CPR and critical care in the same encounter? I don't think Med... Read more
Reader Questions:
Secure Documentation for TP Billing
Question: When technicians in the ED perform suturing and the ED physician then checks and... Read more
Secure Documentation for TP Billing
Question: When technicians in the ED perform suturing and the ED physician then checks and... Read more
Reader Questions:
Report Conscious Sedation Over Anesthesia
Question: The physician's notes state "reduction of shoulder dislocation, IV sedation, tra... Read more
Report Conscious Sedation Over Anesthesia
Question: The physician's notes state "reduction of shoulder dislocation, IV sedation, tra... Read more
Reader Questions:
Only Bill for Atypical Post-Op Care
Question: Can we bill for wound checks? The physician performed an I&D one day, and th... Read more
Only Bill for Atypical Post-Op Care
Question: Can we bill for wound checks? The physician performed an I&D one day, and th... Read more
Reader Questions:
Big Needle Equals Incision
Question: The physician removed a fishhook by inserting an 18-gauge needle into the punctu... Read more
Big Needle Equals Incision
Question: The physician removed a fishhook by inserting an 18-gauge needle into the punctu... Read more
You Be the Coder:
Consider Time - Not E/M Elements - for Critical Care
Question: Does the ED physician need to complete all the HPI, ROS, history, and exam eleme... Read more
Consider Time - Not E/M Elements - for Critical Care
Question: Does the ED physician need to complete all the HPI, ROS, history, and exam eleme... Read more
Here's What to Do With Same-Day Frequent Flyers in the ED
Simple solution eases multiple-visit chaosConfused about the rules regarding multiple ED v... Read more
Simple solution eases multiple-visit chaosConfused about the rules regarding multiple ED v... Read more
The Finer Points of Anesthesia, Conscious Sedation Coding
Providing services and getting paid don't always coincideIf you can't decide when to bill ... Read more
Providing services and getting paid don't always coincideIf you can't decide when to bill ... Read more
Lock In Fracture Care Reimbursement
Expert answers to 3 fracture FAQs seal the dealSeeing physician documentation with cryptic... Read more
Expert answers to 3 fracture FAQs seal the dealSeeing physician documentation with cryptic... Read more
READER QUESTIONS:
Exclude Sedation Code From Fracture Claim
Question: When the ED physician performs a fracture reduction, is conscious sedation inclu... Read more
Exclude Sedation Code From Fracture Claim
Question: When the ED physician performs a fracture reduction, is conscious sedation inclu... Read more
READER QUESTIONS:
All Patients Are New to ED
Question: A patient presented to the ED with a 2-cm uncomplicated laceration to the hand. ... Read more
All Patients Are New to ED
Question: A patient presented to the ED with a 2-cm uncomplicated laceration to the hand. ... Read more
READER QUESTIONS:
Ensure Equivalent X-Ray Report
Question: When the emergency department doctor performs an x-ray interpretation, do we nee... Read more
Ensure Equivalent X-Ray Report
Question: When the emergency department doctor performs an x-ray interpretation, do we nee... Read more
READER QUESTIONS:
Bill For Splint With Direct Application
Question: When can we code for splinting? Does the ED physician need to do a postapplicati... Read more
Bill For Splint With Direct Application
Question: When can we code for splinting? Does the ED physician need to do a postapplicati... Read more
READER QUESTIONS:
Let Physician Hold the 'Key'
Question: We have a patient who presented to the ED with pelvic pain, and we're at a teach... Read more
Let Physician Hold the 'Key'
Question: We have a patient who presented to the ED with pelvic pain, and we're at a teach... Read more
READER QUESTIONS:
Digital Blocks Can Be Separate
Question: Can we ever bill separately for a digital block? If so, when?Arkansas Subscriber... Read more
Digital Blocks Can Be Separate
Question: Can we ever bill separately for a digital block? If so, when?Arkansas Subscriber... Read more
READER QUESTIONS:
Report Worst Fracture First
Question: A patient came into the ED with multiple fractures. How do I know which one to r... Read more
Report Worst Fracture First
Question: A patient came into the ED with multiple fractures. How do I know which one to r... Read more
READER QUESTIONS:
Nix -54 With Laceration Repair
Question: We performed a laceration repair, but because our physician may not end up doing... Read more
Nix -54 With Laceration Repair
Question: We performed a laceration repair, but because our physician may not end up doing... Read more
You Be the Coder:
Clarify Modifier Choice With Payer
Question: The ED physician performed a successful reduction on a patient's hip, and 11 day... Read more
Clarify Modifier Choice With Payer
Question: The ED physician performed a successful reduction on a patient's hip, and 11 day... Read more
Quiz:
Erase Ambiguity When Choosing E/M Levels
Hone your coding skills with these 3 scenarios Choosing between two neighboring E/M level... Read more
Erase Ambiguity When Choosing E/M Levels
Hone your coding skills with these 3 scenarios Choosing between two neighboring E/M level... Read more
Find Positive Answers for 'All Others Negative'
Here's how to handle ROS black holes - and avoid federal scrutiny There's no question tha... Read more
Here's how to handle ROS black holes - and avoid federal scrutiny There's no question tha... Read more
Reader Questions:
Check Slit Lamp for FBR
Question: When an ED physician performs foreign- body removal from the cornea and conjunct... Read more
Check Slit Lamp for FBR
Question: When an ED physician performs foreign- body removal from the cornea and conjunct... Read more
Reader Questions:
Don't Expect Incident-To in the ED
Question: A patient presented in the ED after a fall from a ladder. During the exam, the p... Read more
Don't Expect Incident-To in the ED
Question: A patient presented in the ED after a fall from a ladder. During the exam, the p... Read more
Reader Questions:
Describe Posterior Malleolus With 27760
Question: If the ED physician performed fracture care without manipulation on the patient'... Read more
Describe Posterior Malleolus With 27760
Question: If the ED physician performed fracture care without manipulation on the patient'... Read more
Reader Questions:
Step Lightly With X-Rays
Question: If the documentation proves that the ED physician interpreted a patient's x-ray,... Read more
Step Lightly With X-Rays
Question: If the documentation proves that the ED physician interpreted a patient's x-ray,... Read more
Reader Questions:
Document Critical Care Carefully
Question: My local Medicare payer has recently started denying critical care services, say... Read more
Document Critical Care Carefully
Question: My local Medicare payer has recently started denying critical care services, say... Read more
Reader Questions:
Query Doctor for Critical Care Time
Question: We have a critical care claim in which the physician's documentation meets all c... Read more
Query Doctor for Critical Care Time
Question: We have a critical care claim in which the physician's documentation meets all c... Read more
Reader Questions:
List Worst Fracture First
Question: Which diagnosis code should I list as primary when a patient has multiple fractu... Read more
List Worst Fracture First
Question: Which diagnosis code should I list as primary when a patient has multiple fractu... Read more
Reader Questions:
Learn Key Phrases for Wound Code
Question: The physician documented a 2.2-cm superficial wound on the forearm that primaril... Read more
Learn Key Phrases for Wound Code
Question: The physician documented a 2.2-cm superficial wound on the forearm that primaril... Read more
You Be the Coder:
How Should You Bill for PAs in the ED?
Question: How should I bill for the PAs who are doing procedures in the emergency departme... Read more
How Should You Bill for PAs in the ED?
Question: How should I bill for the PAs who are doing procedures in the emergency departme... Read more
Iron Out Wrinkles in Your Laceration
Know when - and when not - to add wound lengths Need to fine-tune your skills at reportin... Read more
Know when - and when not - to add wound lengths Need to fine-tune your skills at reportin... Read more
Ease MDM Translation With Precise Documentation
Create clearer treatment picture to lock in reimbursement Physicians need to give a step... Read more
Create clearer treatment picture to lock in reimbursement Physicians need to give a step... Read more
Tried and True Tricks for Audit-Proof MDM
7 tips to perfect your E/M choices If indecision about medical decision-making is throwi... Read more
7 tips to perfect your E/M choices If indecision about medical decision-making is throwi... Read more
Know These Payer Nuances for Flawless Observation Coding
Timing, E/M elements are crucial for correct claims Guidelines for reporting observation ... Read more
Timing, E/M elements are crucial for correct claims Guidelines for reporting observation ... Read more
News Brief:
Why Your EMTALA Burdens Could Get Lighter
Improvements in current policies discussed at advisory meeting The Emergency Medical ... Read more
Why Your EMTALA Burdens Could Get Lighter
Improvements in current policies discussed at advisory meeting The Emergency Medical ... Read more
Reader Questions:
When 'Possible,' Code Complaint
Question: A patient presented to the ED with the chief complaint of arm pain. The physicia... Read more
When 'Possible,' Code Complaint
Question: A patient presented to the ED with the chief complaint of arm pain. The physicia... Read more
Reader Questions:
Use -51 for Same-Site Repairs
Question: The ED physician repaired a laceration of the finger (12001) and applied a finge... Read more
Use -51 for Same-Site Repairs
Question: The ED physician repaired a laceration of the finger (12001) and applied a finge... Read more
Reader Questions:
No Admission Necessary for 99291
Question: Can we report critical care codes for a patient who isn't admitted to the hospit... Read more
No Admission Necessary for 99291
Question: Can we report critical care codes for a patient who isn't admitted to the hospit... Read more
Reader Questions:
Check Carrier for X-Ray Rules
Question: Our ED physicians do a lot of their own x-ray interpretations. If they int... Read more
Check Carrier for X-Ray Rules
Question: Our ED physicians do a lot of their own x-ray interpretations. If they int... Read more
Reader Questions:
Assign 2 Codes for 2 Dates
Question: We had a patient seen in the ED at 8 p.m. one day, admitted to observation... Read more
Assign 2 Codes for 2 Dates
Question: We had a patient seen in the ED at 8 p.m. one day, admitted to observation... Read more
Reader Questions:
Report 11040 Over 97597
Question: A patient presented to the ED with canine mastication to the thigh. The physicia... Read more
Report 11040 Over 97597
Question: A patient presented to the ED with canine mastication to the thigh. The physicia... Read more
You Be the Coder:
Include EKG in Chart Notes
Question: Our physicians want to bill for CPT code 93042. Can the "report" be documented o... Read more
Include EKG in Chart Notes
Question: Our physicians want to bill for CPT code 93042. Can the "report" be documented o... Read more
Restore Precision to Your Fracture Coding
Know when to report -54, multiple codes Knowing the requirements for restorative care... Read more
Know when to report -54, multiple codes Knowing the requirements for restorative care... Read more
DOA:
Do You Know What to Do?
Get familiar with what codes to report when a patient dies en routeWhen a patient presents... Read more
Do You Know What to Do?
Get familiar with what codes to report when a patient dies en routeWhen a patient presents... Read more
Beat the OIG to the Punch:
Benchmark Against CMS
Boost your practice's coding accuracy with concrete data from national statsBecause HHS Of... Read more
Benchmark Against CMS
Boost your practice's coding accuracy with concrete data from national statsBecause HHS Of... Read more
READER QUESTIONS:
You Don't Need a Blade to Report Incisions
Question: To bill for removal of a foreign body, the physician must perform an incision, r... Read more
You Don't Need a Blade to Report Incisions
Question: To bill for removal of a foreign body, the physician must perform an incision, r... Read more
READER QUESTIONS:
Tell Both Doctors to Sign at Switch
Question: When a doctor turns a patient over in the middle of his visit due to a shift cha... Read more
Tell Both Doctors to Sign at Switch
Question: When a doctor turns a patient over in the middle of his visit due to a shift cha... Read more
READER QUESTIONS:
Split Codes by Date of Service
Question: A patient presented to the ED on a Monday at 11:05 p.m. The patient received som... Read more
Split Codes by Date of Service
Question: A patient presented to the ED on a Monday at 11:05 p.m. The patient received som... Read more
READER QUESTIONS:
Use 69210 Only for Stubborn Wax
Question: The physician documented that a patient has "wax bilaterally" and that he remove... Read more
Use 69210 Only for Stubborn Wax
Question: The physician documented that a patient has "wax bilaterally" and that he remove... Read more
READER QUESTIONS:
Assign E/M Code for Nonspecific Care
Question: The physician diagnosed a patient with a second-degree burn on her right palm (9... Read more
Assign E/M Code for Nonspecific Care
Question: The physician diagnosed a patient with a second-degree burn on her right palm (9... Read more
READER QUESTIONS:
Rely on Doctor's Word for Diagnosis
Question: The physician's notes state, "Tonsilar swelling, fiery red, no exudate noted. Di... Read more
Rely on Doctor's Word for Diagnosis
Question: The physician's notes state, "Tonsilar swelling, fiery red, no exudate noted. Di... Read more
READER QUESTIONS:
Don't Count on 99371 for ED Service
Question: One of our physicians wants me to bill 99371-99372 for calls and consultations -... Read more
Don't Count on 99371 for ED Service
Question: One of our physicians wants me to bill 99371-99372 for calls and consultations -... Read more
READER QUESTIONS:
Choose Wound Code by Body Surface Percentage
Question: A patient came to the ED with infected decubiti on two sites that required debri... Read more
Choose Wound Code by Body Surface Percentage
Question: A patient came to the ED with infected decubiti on two sites that required debri... Read more
You Be the Coder:
Anesthesia and Procedure in the ED - Who Bills?
Question: Recently, the attending physicians in our ED have been calling anesthesia reside... Read more
Anesthesia and Procedure in the ED - Who Bills?
Question: Recently, the attending physicians in our ED have been calling anesthesia reside... Read more
Critical Care:
Your Most Challenging Questions Answered
Discharged patients may still require 99291 and 99292 Think you can't report critic... Read more
Your Most Challenging Questions Answered
Discharged patients may still require 99291 and 99292 Think you can't report critic... Read more
Focus on Medical Needs to Improve Migraine E/M Coding
Tame your coding headaches with these expert tips When the ED physician treats migraine h... Read more
Tame your coding headaches with these expert tips When the ED physician treats migraine h... Read more
Critical Care:
Are Your Physicians Behind the Curve?
Services increase as clinical acuity sharpens The number of critical care cases reported... Read more
Are Your Physicians Behind the Curve?
Services increase as clinical acuity sharpens The number of critical care cases reported... Read more
Keep Your Eyes Peeled for Signs of Child Abuse
Have the telltale indications on hand with this clip-and-save list Children (and their pa... Read more
Have the telltale indications on hand with this clip-and-save list Children (and their pa... Read more
Reader Questions:
Prove Caveat Intent With a Statement
Question: How does CMS audit records when the acuity caveat is used to explain the ED phys... Read more
Prove Caveat Intent With a Statement
Question: How does CMS audit records when the acuity caveat is used to explain the ED phys... Read more
Reader Questions:
Wait for Report to Describe Cyst
Question: A patient with a growth on the side of his face presented in the ED. The physici... Read more
Wait for Report to Describe Cyst
Question: A patient with a growth on the side of his face presented in the ED. The physici... Read more
Reader Questions:
Check Documentation for Foley Charge
Question: At our facility, we use a supply charge for Foley catheters if they are placed i... Read more
Check Documentation for Foley Charge
Question: At our facility, we use a supply charge for Foley catheters if they are placed i... Read more
Reader Questions:
Find the Injury for Shock Code
Question: What is the diagnosis code for neurogenic shock? I can't find it in the ICD-9 ma... Read more
Find the Injury for Shock Code
Question: What is the diagnosis code for neurogenic shock? I can't find it in the ICD-9 ma... Read more
Reader Questions:
More Physicians Doesn't Mean Higher E/M
Question: The ED doctor sees a child for a fracture. He performs x-rays and administers IV... Read more
More Physicians Doesn't Mean Higher E/M
Question: The ED doctor sees a child for a fracture. He performs x-rays and administers IV... Read more
Reader Questions:
Don't Count on Packing for Complex I&D
Question: Would you clarify the difference between a simple and complex incision and drain... Read more
Don't Count on Packing for Complex I&D
Question: Would you clarify the difference between a simple and complex incision and drain... Read more
Reader Questions:
Report ED-Treated Bleeds
Question: The ED physician cauterized and did a packing for an anterior nosebleed. He call... Read more
Report ED-Treated Bleeds
Question: The ED physician cauterized and did a packing for an anterior nosebleed. He call... Read more
You Be the Coder:
Complex Lacerations in the ED
Question: I've heard that physicians rarely perform complex laceration repair in the ED. I... Read more
Complex Lacerations in the ED
Question: I've heard that physicians rarely perform complex laceration repair in the ED. I... Read more
Quiz:
Submitting Flawless Hospital Bills
See if you can spot the errors in these examples If you think your emergency department (... Read more
Submitting Flawless Hospital Bills
See if you can spot the errors in these examples If you think your emergency department (... Read more
Cut Wound-Care Coding Down to Size
No longer call on 97601 for active wound care In 2005, when the physician removes a ... Read more
No longer call on 97601 for active wound care In 2005, when the physician removes a ... Read more
Remember 3 S's for Trouble-Free Modifier -25 Claims
Significance, separation, and selection will lead you to success Modifier -25 can be your... Read more
Significance, separation, and selection will lead you to success Modifier -25 can be your... Read more
Reader Questions:
Don't Include Postpartum Care for ED Service
Question: If a patient delivers a baby prior to arriving at the emergency department (ED),... Read more
Don't Include Postpartum Care for ED Service
Question: If a patient delivers a baby prior to arriving at the emergency department (ED),... Read more
Reader Questions:
Question Doctor About Tube Letter
Question: Limited documentation from a T-sheet indicates, "J tube replacement and suture i... Read more
Question Doctor About Tube Letter
Question: Limited documentation from a T-sheet indicates, "J tube replacement and suture i... Read more
Reader Questions:
Consult Examples for Help With -52 and -53
Question: I'm trying to figure out how to utilize mod-ifiers -52 and -53. What is the diff... Read more
Consult Examples for Help With -52 and -53
Question: I'm trying to figure out how to utilize mod-ifiers -52 and -53. What is the diff... Read more
Reader Questions:
Describe Gastric Tube With 91105
Question: A patient presents in the emergency department (ED) with rectal bleeding. The ED... Read more
Describe Gastric Tube With 91105
Question: A patient presents in the emergency department (ED) with rectal bleeding. The ED... Read more
Reader Questions:
Navigate Caveat Rules Carefully
Question: I am confused about the proper use of the acuity caveat. I understood that we ca... Read more
Navigate Caveat Rules Carefully
Question: I am confused about the proper use of the acuity caveat. I understood that we ca... Read more
Reader Questions:
Include Hernia Work in ED E/M Code
Question: Since there is no code for manual reduction of an inguinal hernia, is it appropr... Read more
Include Hernia Work in ED E/M Code
Question: Since there is no code for manual reduction of an inguinal hernia, is it appropr... Read more
Reader Questions:
Count 51798 Only Once for Bladder Scanner
Question: We have purchased a bladder scanner to be used in the emergency department. Th... Read more
Count 51798 Only Once for Bladder Scanner
Question: We have purchased a bladder scanner to be used in the emergency department. Th... Read more
You Be the Coder:
Reporting Observation in the ED
Question: I have several questions about observation services in the ED. Is it true that t... Read more
Reporting Observation in the ED
Question: I have several questions about observation services in the ED. Is it true that t... Read more