ED Coding and Reimbursement Alert
ED E/M Coding:
99281-99285: Use NOPP Info to Accurately - Choose MDM Level -- and E/M Code
5 levels of NOPP don't always line up with ED E/M. If you don't have a firm grasp on natur... Read more
99281-99285: Use NOPP Info to Accurately - Choose MDM Level -- and E/M Code
5 levels of NOPP don't always line up with ED E/M. If you don't have a firm grasp on natur... Read more
Lesion removal:
11400-11446: Use These FAQs to Guide Your Suspicious Tissue Removal Coding
Here's why you should never label a lesion malignant on your own. Patients reporting to th... Read more
11400-11446: Use These FAQs to Guide Your Suspicious Tissue Removal Coding
Here's why you should never label a lesion malignant on your own. Patients reporting to th... Read more
Multiple Procedure Coding:
Code Lesion Removals Separately -- Except When You Don't
Complicated repairs require additional coding. So you've got a procedure note in front of ... Read more
Code Lesion Removals Separately -- Except When You Don't
Complicated repairs require additional coding. So you've got a procedure note in front of ... Read more
Reader Questions:
Mind Anatomy on Sub-Q FBRs
Question: I have a puzzling denial in front of me. The ED physician used a scalpel and tw... Read more
Mind Anatomy on Sub-Q FBRs
Question: I have a puzzling denial in front of me. The ED physician used a scalpel and tw... Read more
Reader Questions:
Dig Deep Into Notes to Discern Proper Repair Code
Question: I am a little uncomfortable choosing a code when the physician provides burn tr... Read more
Dig Deep Into Notes to Discern Proper Repair Code
Question: I am a little uncomfortable choosing a code when the physician provides burn tr... Read more
Reader Questions:
Use Modifier Q6 to Represent 'Sub' Physician
Question: One of the ED physicians at our practice is taking some time off, and a tempora... Read more
Use Modifier Q6 to Represent 'Sub' Physician
Question: One of the ED physicians at our practice is taking some time off, and a tempora... Read more
Reader Questions:
Sidestep Foot FBR Issues If Physician Makes Incision
Question: A patient reports to the ED with a bruised foot that is slightly bloody in the ... Read more
Sidestep Foot FBR Issues If Physician Makes Incision
Question: A patient reports to the ED with a bruised foot that is slightly bloody in the ... Read more
Reader Questions:
Anemia Could Lead to H1N1 Admin
Question: A 48-year-old female, fearing she has H1N1, reports to the ED complaining of we... Read more
Anemia Could Lead to H1N1 Admin
Question: A 48-year-old female, fearing she has H1N1, reports to the ED complaining of we... Read more
You Be the Coder:
Laceration Repair or E/M?
Question: A patient reports to the ED with a laceration just above his right eyebrow; he ... Read more
Laceration Repair or E/M?
Question: A patient reports to the ED with a laceration just above his right eyebrow; he ... Read more
Foreign body removal:
65205-65222: Eye that FBR claim for removal area
Corneal may also call for slit lamp use.A patient reports to the ED with a foreign body in... Read more
65205-65222: Eye that FBR claim for removal area
Corneal may also call for slit lamp use.A patient reports to the ED with a foreign body in... Read more
Coding 101:
E/M Services Call for Modifier 25, But Only When Necessary
Auditors could get interested if you misuse this modifier.Knowing when to append a modifie... Read more
E/M Services Call for Modifier 25, But Only When Necessary
Auditors could get interested if you misuse this modifier.Knowing when to append a modifie... Read more
2011 Fee Schedule Update:
CMS set to slash 2011 conversion factor … But Watch for changes
Feds could still change cuts before implementation date.Get ready for another year of nail... Read more
CMS set to slash 2011 conversion factor … But Watch for changes
Feds could still change cuts before implementation date.Get ready for another year of nail... Read more
Reader Questions:
Include modifier to reflect 'partial' removals
Question: Documentation states that the physician personally removed a small portion of im... Read more
Include modifier to reflect 'partial' removals
Question: Documentation states that the physician personally removed a small portion of im... Read more
Reader Questions:
Offer ICD-9 trio for post-TBI patient
Question: A 25-year-old male presents complaining of "blackouts" that have occurred within... Read more
Offer ICD-9 trio for post-TBI patient
Question: A 25-year-old male presents complaining of "blackouts" that have occurred within... Read more
Reader Questions:
Observe trephination rules or end up with claim rejection
Question: A patient reports to the ED with blood and pus under his left third and fourth d... Read more
Observe trephination rules or end up with claim rejection
Question: A patient reports to the ED with blood and pus under his left third and fourth d... Read more
Reader Questions:
Choose correct modifiers eafor procedure, E/M portions of visit
Question: A patient reports to the ED with a closed dislocation of the left hip. After per... Read more
Choose correct modifiers eafor procedure, E/M portions of visit
Question: A patient reports to the ED with a closed dislocation of the left hip. After per... Read more
Reader Questions:
Tread with caution if considering DOA billing
Question: A patient arrives at the ED dead on arrival; the emergency medical technic... Read more
Tread with caution if considering DOA billing
Question: A patient arrives at the ED dead on arrival; the emergency medical technic... Read more
Reader Questions:
Coder Carve-Outs Necessary for Spot-On Critical Care Claims
Question: The ED physician recently provided an extensive service for a critically ill pat... Read more
Coder Carve-Outs Necessary for Spot-On Critical Care Claims
Question: The ED physician recently provided an extensive service for a critically ill pat... Read more
Reader Questions:
Local Treatment Could Unlock Burn Code Pay
Question: A patient reports to the ED with swelling and minor blisters on the tops of his ... Read more
Local Treatment Could Unlock Burn Code Pay
Question: A patient reports to the ED with swelling and minor blisters on the tops of his ... Read more
You Be the Coder:
Lesions in different anatomical areas
Question: A patient presents to the ED with a lesion on his forehead and one on his neck; ... Read more
Lesions in different anatomical areas
Question: A patient presents to the ED with a lesion on his forehead and one on his neck; ... Read more
CPT 2011:
99224, 99225, 99226 'Middle Day'
Along with observation set expansion, new manual opens up options for ultrasound on extrem... Read more
99224, 99225, 99226 'Middle Day'
Along with observation set expansion, new manual opens up options for ultrasound on extrem... Read more
CPT 2011 Clinical Corner:
Use This Expert Scenario to Get a Grip on 99224-99226 Situations
'Middle day' observation codes are game changers for patients in observation 3+ days.Coder... Read more
Use This Expert Scenario to Get a Grip on 99224-99226 Situations
'Middle day' observation codes are game changers for patients in observation 3+ days.Coder... Read more
Fast Exam FAQ:
Code Slowly or Risk Errors on 2-Part FAST Exam
This exam requires a pair of procedures -- and don't forget about that E/M, either.Co... Read more
Code Slowly or Risk Errors on 2-Part FAST Exam
This exam requires a pair of procedures -- and don't forget about that E/M, either.Co... Read more
Reader Questions:
Choose Highest-Level of Burn 1st on Dx List
Question: After a level-two ED E/M service, the physician performs local burn treatment wi... Read more
Choose Highest-Level of Burn 1st on Dx List
Question: After a level-two ED E/M service, the physician performs local burn treatment wi... Read more
Reader Questions:
Opt for Symptoms on 'Worried Well Check'
Question: A mother brought her child to our ED because her 8-month-old daughter was "actin... Read more
Opt for Symptoms on 'Worried Well Check'
Question: A mother brought her child to our ED because her 8-month-old daughter was "actin... Read more
Reader Questions:
In ED, 'Without Anesthesia' Code Fits the Bill
Question: A patient reports to the ED complaining of severe right elbow pain. After an exp... Read more
In ED, 'Without Anesthesia' Code Fits the Bill
Question: A patient reports to the ED complaining of severe right elbow pain. After an exp... Read more
Reader Questions:
Don't Turn Your Nose Up at These FBR Codes
Question: A patient reports to the ED with a crayon stuck in his left nostril. The physici... Read more
Don't Turn Your Nose Up at These FBR Codes
Question: A patient reports to the ED with a crayon stuck in his left nostril. The physici... Read more
You Be the Coder:
Look to Wound Margins for Debridement Clues
Question: The physician performs a level-three ED E/M service, and then performs debrideme... Read more
Look to Wound Margins for Debridement Clues
Question: The physician performs a level-three ED E/M service, and then performs debrideme... Read more
Critical Care Coding:
Use These Strategies To Upgrade Your CC Claims Success
Experts differ on +99292 coding, so be sure to check with payer.ED coders should strive to... Read more
Use These Strategies To Upgrade Your CC Claims Success
Experts differ on +99292 coding, so be sure to check with payer.ED coders should strive to... Read more
Critical Care Tips:
Check With Payer Before Considering +99292 Rules
Some recommend a '15-minute rule' on critical care add-on.When providing critical care, th... Read more
Check With Payer Before Considering +99292 Rules
Some recommend a '15-minute rule' on critical care add-on.When providing critical care, th... Read more
Common ED Procedure Coding:
Look to Instrumentation for Cerumen Removal Coding Clues
If cerumen is non-impacted, opt for E/M.When patient's report to the ED with painful, infe... Read more
Look to Instrumentation for Cerumen Removal Coding Clues
If cerumen is non-impacted, opt for E/M.When patient's report to the ED with painful, infe... Read more
Reader Questions:
Consider Secondary Diagnoses on Multi-Complaint Patients
Question: A patient presents to the ED complaining of a headache that has gotten progressi... Read more
Consider Secondary Diagnoses on Multi-Complaint Patients
Question: A patient presents to the ED complaining of a headache that has gotten progressi... Read more
Reader Questions:
Check Catheter Use for Thoracentesis Type Clues
Question: A 50-year-old male patient is brought to the ED via ambulance; the emergency med... Read more
Check Catheter Use for Thoracentesis Type Clues
Question: A 50-year-old male patient is brought to the ED via ambulance; the emergency med... Read more
Reader Questions:
Look to 11040 When Notes Include 'Mostly Dermal'
Question: A father brings his 6-year-old son into the ED after the boy suffered a bicycle ... Read more
Look to 11040 When Notes Include 'Mostly Dermal'
Question: A father brings his 6-year-old son into the ED after the boy suffered a bicycle ... Read more
Reader Questions:
Look to 11040 When Notes Include 'Mostly Dermal'
Question: A father brings his 6-year-old son into the ED after the boy suffered a bicycle ... Read more
Look to 11040 When Notes Include 'Mostly Dermal'
Question: A father brings his 6-year-old son into the ED after the boy suffered a bicycle ... Read more
Reader Questions:
Remember Different ED Rules for TPIs, Other Injections
Question: A patient reports to the ED complaining of severe neck pain. He reports that two... Read more
Remember Different ED Rules for TPIs, Other Injections
Question: A patient reports to the ED complaining of severe neck pain. He reports that two... Read more
Reader Questions:
Local Treatment Could Unlock Burn Code Pay
Question: A patient reports to the ED with swelling and minor blisters on the tops of his ... Read more
Local Treatment Could Unlock Burn Code Pay
Question: A patient reports to the ED with swelling and minor blisters on the tops of his ... Read more
Reader Questions:
Encourage Physicians to Observe Signature Rules
Question: One of our physicians likes to sign everything with just his initials, or someti... Read more
Encourage Physicians to Observe Signature Rules
Question: One of our physicians likes to sign everything with just his initials, or someti... Read more
You Be the Coder:
To Combine, or Not to Combine: Laceration Repair Lengths
Question: A patient reports to the ED with a pair of lacerations; notes indicate that afte... Read more
To Combine, or Not to Combine: Laceration Repair Lengths
Question: A patient reports to the ED with a pair of lacerations; notes indicate that afte... Read more
Common ED Debridements:
Ride These 3 FAQs to Debridement Coding Success
Multiple lesions, multiple codes? Maybe. When your ED physician performs debridements,... Read more
Ride These 3 FAQs to Debridement Coding Success
Multiple lesions, multiple codes? Maybe. When your ED physician performs debridements,... Read more
High-Level Debridements:
Spot Deeper Debridements or Drop Almost $200 From Claim
Coders should be ready for higher-level services just in case.ED physicians' debridement s... Read more
Spot Deeper Debridements or Drop Almost $200 From Claim
Coders should be ready for higher-level services just in case.ED physicians' debridement s... Read more
ED E/M Coding:
Heed HPI Count, or Risk Running Into Red Tape
Note slight differences in HPI rules among payers.Coders that cannot identify history of p... Read more
Heed HPI Count, or Risk Running Into Red Tape
Note slight differences in HPI rules among payers.Coders that cannot identify history of p... Read more
Reader Questions:
Use ICD-9 Smarts to Make Hematuria Dx Choice Simple
Question: A patient reports to the ED complaining of severe stomach pain and trouble urina... Read more
Use ICD-9 Smarts to Make Hematuria Dx Choice Simple
Question: A patient reports to the ED complaining of severe stomach pain and trouble urina... Read more
Reader Questions:
E/M Code Keys Your PQRI Claim
Question: Our ED wants to report on the physician quality reporting initiative (PQRI) meas... Read more
E/M Code Keys Your PQRI Claim
Question: Our ED wants to report on the physician quality reporting initiative (PQRI) meas... Read more
Reader Questions:
Remember, Hydration Codes Won't Hold Water With Payers
Question: A 94-year-old nursing home patient arrives to the ED via ambulance after her gas... Read more
Remember, Hydration Codes Won't Hold Water With Payers
Question: A 94-year-old nursing home patient arrives to the ED via ambulance after her gas... Read more
Reader Questions:
If Cancer's Still Present, Ignore 'History of' Codes
Question: At what point should I report a "history of" code instead of the actual cancer d... Read more
If Cancer's Still Present, Ignore 'History of' Codes
Question: At what point should I report a "history of" code instead of the actual cancer d... Read more
Reader Questions:
Be Careful You Don't Overcode Thoracentesis Services
Question: Encounter notes state that the physician treats a patient suffering from exudati... Read more
Be Careful You Don't Overcode Thoracentesis Services
Question: Encounter notes state that the physician treats a patient suffering from exudati... Read more
You Be the Coder:
Use Broken Skin As Clue to Proper Wound Dx
Question: A patient reports to the ED after suffering a dog bite on her right forearm; The... Read more
Use Broken Skin As Clue to Proper Wound Dx
Question: A patient reports to the ED after suffering a dog bite on her right forearm; The... Read more
Payment Generating Procedures:
Bust 2 Incision and Drainage Myths and Sidestep I&D Abscess Denials
You'll get twice the payment when you know where to look.Summer brings an influx of patien... Read more
Bust 2 Incision and Drainage Myths and Sidestep I&D Abscess Denials
You'll get twice the payment when you know where to look.Summer brings an influx of patien... Read more
Abdominal Pain Dx:
Location Is Everything When You Report Abdominal Pain
Follow these 3 tips for successful coding now -- and later.The term "abdominal pain" ... Read more
Location Is Everything When You Report Abdominal Pain
Follow these 3 tips for successful coding now -- and later.The term "abdominal pain" ... Read more
Diagnosis Coding News:
CMS Quashes Rumors About ICD-10 Implementation Delay
Plus: CMS has proposed freezing the ICD-9 code set after next year.If you were hoping that... Read more
CMS Quashes Rumors About ICD-10 Implementation Delay
Plus: CMS has proposed freezing the ICD-9 code set after next year.If you were hoping that... Read more
Reader Questions:
Evaluate Services For Gun Shot Wound
Question: I am trying to code a chest exploration following a gun shot wound. Would I use ... Read more
Evaluate Services For Gun Shot Wound
Question: I am trying to code a chest exploration following a gun shot wound. Would I use ... Read more
Reader Questions:
Choose Between 917.8, 917.9 for Toe Tourniquet
Question: The physician removed a "hair tourniquet" of human hair wound tightly around a p... Read more
Choose Between 917.8, 917.9 for Toe Tourniquet
Question: The physician removed a "hair tourniquet" of human hair wound tightly around a p... Read more
Reader Questions:
Be Confident in Coding for Teaching Physicians
Question: A resident in the ED sees a new patient complaining of heartburn. The resident c... Read more
Be Confident in Coding for Teaching Physicians
Question: A resident in the ED sees a new patient complaining of heartburn. The resident c... Read more
Reader Questions:
Keep Same HTN Code for Uncontrolled/Controlled
Question:Does ICD-9 distinguish controlled and uncontrolled hypertension (HTN)?Missouri Su... Read more
Keep Same HTN Code for Uncontrolled/Controlled
Question:Does ICD-9 distinguish controlled and uncontrolled hypertension (HTN)?Missouri Su... Read more
Reader Questions:
Anemia or Underlying Disease? You Decide
Question: A patient with mild (stage II) chronic kidney disease presented for increased le... Read more
Anemia or Underlying Disease? You Decide
Question: A patient with mild (stage II) chronic kidney disease presented for increased le... Read more
Reader Questions:
Check If Exceptions Exist in Fracture Modifiers
Question: A parent brings her 14-year-old son to the ED with an injured right finger he su... Read more
Check If Exceptions Exist in Fracture Modifiers
Question: A parent brings her 14-year-old son to the ED with an injured right finger he su... Read more
You Be the Coder:
Make 948 Your Burn Coding Constant
Question: Do I need to include a code from category 948 on every claim for burn victims?Mi... Read more
Make 948 Your Burn Coding Constant
Question: Do I need to include a code from category 948 on every claim for burn victims?Mi... Read more
Break Fact, Fiction Apart on Your Fracture Care Claims
The break of a bone does not always mean a fracture code.A patient presents to the ED with... Read more
The break of a bone does not always mean a fracture code.A patient presents to the ED with... Read more
Orderly Multi-Fracture Coding a Must for Max Payout
Check RVUs before settling on the first fracture care code to report.When your ED physicia... Read more
Check RVUs before settling on the first fracture care code to report.When your ED physicia... Read more
ICD-9 2011:
New Traumatic Brain Injury, Pneumonia Codes Ease Your Reporting
Jaw pain also gets a nod in new code set.Last month, we brought you some of the most impor... Read more
New Traumatic Brain Injury, Pneumonia Codes Ease Your Reporting
Jaw pain also gets a nod in new code set.Last month, we brought you some of the most impor... Read more
Reader Questions:
Count Systems, Not Symptoms, On ROS Levels
Question:What do you think the review of systems (ROS) level would be for the following en... Read more
Count Systems, Not Symptoms, On ROS Levels
Question:What do you think the review of systems (ROS) level would be for the following en... Read more
Reader Questions:
Use This Critical Info to Key to TP E/Ms
Question:One of our ED physicians and a resident performed a level-three ED E/M service fo... Read more
Use This Critical Info to Key to TP E/Ms
Question:One of our ED physicians and a resident performed a level-three ED E/M service fo... Read more
Reader Questions:
Make Separate Nature Clear, Give I&D -- E/M Claims Wings
Question:A patient reports to the ED with a cyst in the mucosal tissue of her left cheek. ... Read more
Make Separate Nature Clear, Give I&D -- E/M Claims Wings
Question:A patient reports to the ED with a cyst in the mucosal tissue of her left cheek. ... Read more
Reader Questions:
NOPP Can Push Physician's MDM Up
Question:A 45-year-old male patient reports to the ED with chest pain and mild shortness o... Read more
NOPP Can Push Physician's MDM Up
Question:A 45-year-old male patient reports to the ED with chest pain and mild shortness o... Read more
Reader Questions:
Remember Difference Between Debridement, Wound Management
Question:When the physician cleans a wound and surrounding infected tissue by scraping wit... Read more
Remember Difference Between Debridement, Wound Management
Question:When the physician cleans a wound and surrounding infected tissue by scraping wit... Read more
Reader Questions:
I&D Area Can Deflate 10060 Option
Question:The ED physician performs a level-four E/M service for a patient and diagnoses a ... Read more
I&D Area Can Deflate 10060 Option
Question:The ED physician performs a level-four E/M service for a patient and diagnoses a ... Read more
You Be the Coder:
Code Critical Care and Additional Services
Question:The ED physician spends a total of 108 minutes caring exclusively for a criticall... Read more
Code Critical Care and Additional Services
Question:The ED physician spends a total of 108 minutes caring exclusively for a criticall... Read more
Step-by-Step Coding:
Count Layers to Smoke Out Burn Claims Cash
Did doc deal with blisters? It could be a partial-thickness treatment.Summer's the season ... Read more
Count Layers to Smoke Out Burn Claims Cash
Did doc deal with blisters? It could be a partial-thickness treatment.Summer's the season ... Read more
Make Sure You're Checking for High-Level E/M on Burn Treatments
'Aggressive monitoring' might add digits to E/M level.Patients reporting to the ED for bur... Read more
'Aggressive monitoring' might add digits to E/M level.Patients reporting to the ED for bur... Read more
Mythbusters:
Eyeing That Procedure Code? Here's Some Advice on When to Choose an E/M Instead
These 3 scenarios all look like procedures, but 2 are actually E/Ms.Sometimes, encounter n... Read more
Eyeing That Procedure Code? Here's Some Advice on When to Choose an E/M Instead
These 3 scenarios all look like procedures, but 2 are actually E/Ms.Sometimes, encounter n... Read more
ICD-9 2011:
New Dx Codes Help You Justify Critical Care Coding
Jaw pain, drug OD codes highlight new ED-relevant Dxs.On Oct. 1, ED coders will have sever... Read more
New Dx Codes Help You Justify Critical Care Coding
Jaw pain, drug OD codes highlight new ED-relevant Dxs.On Oct. 1, ED coders will have sever... Read more
Reader Questions:
Note Injection Differences to Shoot Straight on Intervention Coding
Question: A female patient with a history of menstrual migraines presents with an onset of... Read more
Note Injection Differences to Shoot Straight on Intervention Coding
Question: A female patient with a history of menstrual migraines presents with an onset of... Read more
Reader Questions:
Ensure Primary Dx Code for 'Secondary Diabetics
Question: I have a puzzling claim in front of me. The notes indicate that the nonphysician... Read more
Ensure Primary Dx Code for 'Secondary Diabetics
Question: I have a puzzling claim in front of me. The notes indicate that the nonphysician... Read more
Reader Questions:
Use E-V Code Combo to Code 'Injury-Free' E/Ms
Question: A substantial number of people who report to our ED after auto accidents end up ... Read more
Use E-V Code Combo to Code 'Injury-Free' E/Ms
Question: A substantial number of people who report to our ED after auto accidents end up ... Read more
Reader Questions:
Pay Attention to Modifiers on Ultrasound Interps
Question: A 26-year-old patient who is 24 weeks pregnant presents to the ED; "I been throw... Read more
Pay Attention to Modifiers on Ultrasound Interps
Question: A 26-year-old patient who is 24 weeks pregnant presents to the ED; "I been throw... Read more
You Be the Coder:
Reporting Incomplete Lumbar Punctures
Question: A 62-year-old male patient reports to the ED via ambulance. The emergency medica... Read more
Reporting Incomplete Lumbar Punctures
Question: A 62-year-old male patient reports to the ED via ambulance. The emergency medica... Read more
Get Your Cut for Soft Tissue FBRs by Looking for Incision Evidence
Complicated FBRs, though rare, pay twice as much as simple ones. Ah, spring. The birds, t... Read more
Complicated FBRs, though rare, pay twice as much as simple ones. Ah, spring. The birds, t... Read more
Don't Let Foot FBR Definition Fool You
Survey says: Incision required for foot FBR. A girl limps into the ED with a splinter in ... Read more
Survey says: Incision required for foot FBR. A girl limps into the ED with a splinter in ... Read more
ED-Specific Exception Allows You to Sidestep Some HPI Rules
Use these FAQs to achieve level 5. A patient reports to the ED in such severe respiratory... Read more
Use these FAQs to achieve level 5. A patient reports to the ED in such severe respiratory... Read more
Check for Critical Care, Gain $50 for Some Caveat Patients
If patient's critical care and visit satisfies time regs, 99291 is the better bet. When s... Read more
If patient's critical care and visit satisfies time regs, 99291 is the better bet. When s... Read more
Reader Questions:
Document Traditional Tx Tries on Carpal Tunnel
Question: A 37-year-old librarian reports to the ED reporting pain at the base of her rig... Read more
Document Traditional Tx Tries on Carpal Tunnel
Question: A 37-year-old librarian reports to the ED reporting pain at the base of her rig... Read more
Reader Questions:
Consider Bundles Before Upping Repair Level
Question: A patient reports to the ED bleeding moderately from the scalp. The patient is ... Read more
Consider Bundles Before Upping Repair Level
Question: A patient reports to the ED bleeding moderately from the scalp. The patient is ... Read more
Reader Questions:
Use 3 Code-Pairs to Ace This X-Ray Claim
Question: A 38-year-old patient reports to the ED with complaints of wheezing, coughing, ... Read more
Use 3 Code-Pairs to Ace This X-Ray Claim
Question: A 38-year-old patient reports to the ED with complaints of wheezing, coughing, ... Read more
Reader Questions:
Check Descriptors on Tough P Mod Calls
Question: A patient is brought to the ED via ambulance with acute myocardial infarction (... Read more
Check Descriptors on Tough P Mod Calls
Question: A patient is brought to the ED via ambulance with acute myocardial infarction (... Read more
Reader Questions:
Don't Let Shorthand Block You From Correct Code
Question: A patient reports to the ED at 8 a.m. on a Sunday morning. He reports a horribl... Read more
Don't Let Shorthand Block You From Correct Code
Question: A patient reports to the ED at 8 a.m. on a Sunday morning. He reports a horribl... Read more
You Be the Coder:
Moderate Sedation and the Separation Repair
Question: A 14-year-old patient reports to the ED with an injured right shoulder. While s... Read more
Moderate Sedation and the Separation Repair
Question: A 14-year-old patient reports to the ED with an injured right shoulder. While s... Read more
Measurement Smarts Might Mean More on Excision Claims
Here's why waiting on path report doesn't work for most EDs. Coders unwilling to delve in... Read more
Here's why waiting on path report doesn't work for most EDs. Coders unwilling to delve in... Read more
Modifiers, not Math, Make Multi-Excision Claims Go
Measuring total removal lengths is a no-no ... here's why. Your ED physician removes a pa... Read more
Measuring total removal lengths is a no-no ... here's why. Your ED physician removes a pa... Read more
Follow This FAQ to Ensure ROS Level Success
CPT or CMS? Be sure you know whose ROS rules private payers follow. A lack of E/M coding ... Read more
CPT or CMS? Be sure you know whose ROS rules private payers follow. A lack of E/M coding ... Read more
Put Critical Care Clock on Pause Until Physician Returns
Check out this advice on 'split'CC visits. When the ED physician leaves a critically ill ... Read more
Check out this advice on 'split'CC visits. When the ED physician leaves a critically ill ... Read more
READER QUESTIONS:
Counseling Exception? Not in ED
Question: A patient with a chronic gastric ulcer reports to the ED complaining of nausea,... Read more
Counseling Exception? Not in ED
Question: A patient with a chronic gastric ulcer reports to the ED complaining of nausea,... Read more
READER QUESTIONS:
Without 5th Digit, No Migraine Dx is Complete
Question: A patient presents to the ED with complaints of a headache that's worsening dai... Read more
Without 5th Digit, No Migraine Dx is Complete
Question: A patient presents to the ED with complaints of a headache that's worsening dai... Read more
READER QUESTIONS:
I&D Area Can Deflate 10060 Option
Question: The ED physician performs a level-four E/M service for a patient and diagnoses ... Read more
I&D Area Can Deflate 10060 Option
Question: The ED physician performs a level-four E/M service for a patient and diagnoses ... Read more
READER QUESTIONS:
Separate Splinting From Fracture Repair
Question: A 33-year-old patient reports to the ED with a badly injured left arm. The ED p... Read more
Separate Splinting From Fracture Repair
Question: A 33-year-old patient reports to the ED with a badly injured left arm. The ED p... Read more
You Be the Coder :
Diagnosis Coding for Multiple Burns
Question: A patient is brought to the ED via ambulance after standing too close to a Roma... Read more
Diagnosis Coding for Multiple Burns
Question: A patient is brought to the ED via ambulance after standing too close to a Roma... Read more
Follow This FAQ to Max Out Critical Care Payoff
Experts: Make sure physician knows what to count toward 99291. Your ED physician provides... Read more
Experts: Make sure physician knows what to count toward 99291. Your ED physician provides... Read more
Case Study Challenge:
Check Your CC Knowledge by Digging Into These Detailed Scenarios
You want clinical critical care examples? You got 'em. The ins and outs of critical care ... Read more
Check Your CC Knowledge by Digging Into These Detailed Scenarios
You want clinical critical care examples? You got 'em. The ins and outs of critical care ... Read more
News you can use:
Feds Up Conversion Factor Rate -- For Now
Also: Here's why you shouldn't freak out if your MAC payments are a bit late. Remember th... Read more
Feds Up Conversion Factor Rate -- For Now
Also: Here's why you shouldn't freak out if your MAC payments are a bit late. Remember th... Read more
Use TPI Do's and Don'ts to Target Winning Claims
Documentation detailing these injection encounters can fortify claim. Counting the right ... Read more
Documentation detailing these injection encounters can fortify claim. Counting the right ... Read more
Readers Question:
High MDM Highlights Caveat Claims
Question: A patient from a nearby nursing home reports to the ED with a low-grade fever. ... Read more
High MDM Highlights Caveat Claims
Question: A patient from a nearby nursing home reports to the ED with a low-grade fever. ... Read more
Readers Question:
Bilateral Earwax = Single Code
Question: A patient reports to the ED complaining of pain in both her ears and a massive ... Read more
Bilateral Earwax = Single Code
Question: A patient reports to the ED complaining of pain in both her ears and a massive ... Read more
Readers Question:
PFSH Puts Added Value on Some E/Ms
Question: I am having trouble deciding between E/M levels for this encounter: The notes c... Read more
PFSH Puts Added Value on Some E/Ms
Question: I am having trouble deciding between E/M levels for this encounter: The notes c... Read more
Readers Question:
Remember to Represent Pressure Ulcer's Stage
Question: An elderly patient reports to the ED for inspection of sores on her back. The n... Read more
Remember to Represent Pressure Ulcer's Stage
Question: An elderly patient reports to the ED for inspection of sores on her back. The n... Read more
You be the coder:
High-Level E/Ms and Burn Patients
Question: A 42-year-old female is brought to the ED by ambulance after being rescued from... Read more
High-Level E/Ms and Burn Patients
Question: A 42-year-old female is brought to the ED by ambulance after being rescued from... Read more
Be Alert on Nosebleed Fixes, or Risk Leaving $60 on table
Separate E/M almost a give for anterior ED repairs.Patients reporting to the ED for treatm... Read more
Separate E/M almost a give for anterior ED repairs.Patients reporting to the ED for treatm... Read more
Ensure Patient's In 'Status Limbo'Before Coding Observation
Recent Medicare clarification nixes '8-hour rule.'Reporting your ED physician's observatio... Read more
Recent Medicare clarification nixes '8-hour rule.'Reporting your ED physician's observatio... Read more
Term Knowledge Can Correct Nosebleed Fix Claims
Silver nitrate often equals 30901.So you've got a claim in front of you that could qualify... Read more
Silver nitrate often equals 30901.So you've got a claim in front of you that could qualify... Read more
Use Shared Visit to Capitalize on NPP/Physician Teamwork
Forget about incident-to in the facility,but consider this similar billing technique.ED co... Read more
Forget about incident-to in the facility,but consider this similar billing technique.ED co... Read more
Reader Questions :
Look for Incision Evidence in FBR Scenarios
Question: A 47-year-old male reports to the ED complaining of a painful, swollen, and redd... Read more
Look for Incision Evidence in FBR Scenarios
Question: A 47-year-old male reports to the ED complaining of a painful, swollen, and redd... Read more
Reader Questions :
Ear Wick Won't Equal Procedure Code
Question: A 34-year-old male patient reports to the ED complaining of pain and itchin... Read more
Ear Wick Won't Equal Procedure Code
Question: A 34-year-old male patient reports to the ED complaining of pain and itchin... Read more
Reader Questions :
Consider Immediacy on Critical Care Claims
Question: I've experienced some denials on critical care codes for patients I considered t... Read more
Consider Immediacy on Critical Care Claims
Question: I've experienced some denials on critical care codes for patients I considered t... Read more
Reader Questions :
Note ED Exceptions When Considering Codes
Question: A patient reports to the ED complaining of dehydration, weakness, and flu-like s... Read more
Note ED Exceptions When Considering Codes
Question: A patient reports to the ED complaining of dehydration, weakness, and flu-like s... Read more
Reader Questions :
Remember Primary Dx Code for These Diabetics
Question: I have a puzzling claim in front of me. The notes indicate that the nonphysician... Read more
Remember Primary Dx Code for These Diabetics
Question: I have a puzzling claim in front of me. The notes indicate that the nonphysician... Read more
You Be the Coder:
Pay Attention to Payer on Fracture Modifiers
Question: A patient reports to the ED with an injured right finger he suffered during a sk... Read more
Pay Attention to Payer on Fracture Modifiers
Question: A patient reports to the ED with an injured right finger he suffered during a sk... Read more