ED Coding and Reimbursement Alert
Keep These Charts Handy To Compare Your 2016 and 2017 RVUs For ED Services
Although there were some minor tweaks to the PE and PLI RVUS, the net impact rounds to zero for the E/M codes listed. Check out how your common diagnoses’ relative value units (RVU) will be impacted. Breathe Easy with an Increase in Intubation Values Emergency medicine has some good news with a significant increase in the work value of code 31500 (Intubation, endotracheal, emergency procedure). The 2017 work value is 3.00, an increase of 29 percent over the 2016 work value of 2.33. The code recently was reviewed by the RUC and has now been removed from the CMS list of codes considered to be potentially misvalued, says Granovsky. In the final rule, CMS notes that the RUC had recommend a value of 3.0, but CMS had proposed a work value of 2.66 instead. However, after commenters noted the intra service time had doubled from 5 to 10 minutes and the intense, emergent nature of this procedure, CMS reconsidered and accepted the higher value in the final rule. You should see higher payments for code 31500 in 2017, Granovsky explains. Watch For Future Review of Common ED Procedures Look at these 0-day global services that are typically billed with an evaluation and management (E/M) service with modifier 25 (Significant, separately identifiable E/M service by the same physician on the same day as a procedure…) highlighting ED relevant codes. CMS has noted coders typically report several high volume procedure codes currently valued with routine visits as part of the global with a modifier that allows separate payment for visits — even though the modifier should only be used for reporting services beyond those usually provided. Therefore, CMS believes the services may be misvalued. As a result, CMS is prioritizing 19 services for review as potentially misvalued and intends to investigate this policy concern in future rulemaking, Granovsky says. Table 8 of the Final Rule lists several procedures CMS will be reviewing that are relevant to the ED including:
ED Coding and Reimbursement Alert
- Medicare Physician Fee Schedule:
2017 Medicare Fee Schedule Brings Good News for Emergency Physicians
Look for an increase in intubation procedures while ED E/M codes remain stable. The 2017 [...] - Telehealth Rules for 2017:
CMS Adds New Place Of Service Modifier for Telehealth Services
New telehealth POS 2 code for distant site from where the patient is being treated. [...] - 2017 Physician Fee Schedule:
Keep These Charts Handy To Compare Your 2016 and 2017 RVUs For ED Services
Although there were some minor tweaks to the PE and PLI RVUS, the net impact [...] - FBR Eye:
Check 3 Details When Coding Ocular Foreign Body Removals
Look closely at the documentation for these clues to determine the right code. Consider a [...] - You Be the Coder:
Is This a Level 3 or a Level 4 ED E/M Service? Find Out
Question: Other coders and I disagree about this chart: ED NOTE: CHIEF COMPLAINT/REASON FOR VISIT: Fever - Reader Question:
Check the 2017 Chart for Time Requirements on Additional Units of Moderate Sedation
Question: I read in the November issue that the new moderate sedation codes require a minimum [...]
