ED Coding and Reimbursement Alert

Question: What diagnosis code should we assign for patient visits with the final diagnosis normal exam?

California Subscriber

Answer: If possible, code for the primary reason the person came to the ED. For example, if the patient presented with fever or chest pain, use codes associated with those symptoms even if that particular problem is gone or not found on exam. And, if the physician, finding nothing on exam, provides no record of the original complaint(s), use the appropriate V or E diagnosis codes to support the presenting problem. However, many payers do not reimburse if you submit only V or E codes. Its important to remember that you might not get reimbursed, but you still have to report, and this might be your only coding option.