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ED Coding and Reimbursement Alert

How Can I Check Our 99231 Claims?

Published on Sun Sep 19, 2004

Random sample reveals patterns If your ED practice repeatedly reports the same subsequent hospital care code, you should perform a chart review to ensure you're accurately coding the visits, coding experts say.
  
Take a random sampling of charts in which you reported 99231, and on each file you should determine the history, exam and medical decision-making levels and determine whether they meet the requirements for 99232 or 99233, says Laureen Jandroep, OTR, CPC, CCS-P, CPC-H, CCS, director and senior instructor for the CRN Institute, an online coding certification training center.
 
Helpful hint: If the emergency physician is called to the floor for a very serious problem, consider coding critical care if it's appropriate and the required time thresholds are met. Also, don't forget to code for any separately billable procedures.
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