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ED Coding and Reimbursement Alert

Compliance Strategies:

Know The Rules For Freestanding ED Or You Could Be Standing In Front Of A Judge

Published on Thu Aug 16, 2012

Definitions and certifications are vital to code correctly in these venues. Off-campus urgent and emergency care centers are popping up across the country, creating in their wake significant confusion for coders about which E/M code set to use in billing E/M services provided in these settings. To complicate things further, coders for freestanding EDs need to be aware of the rules governing whether or not a facility code can be charged for the visit in addition to a professional charge. Chart your path to compliant freestanding ED coding with these basics. Added complexity: Both state and individual payer guidelines may govern how these facilities are designated and, thus, how services are billed. Medicare has its own requirements for how a freestanding "emergency center" can be designated as a true emergency department and urgent care centers are defined in a completely separate category with different coding requirements. Get the Lowdown: Hospital-Owned [...]
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