ED Coding and Reimbursement Alert

Question: What is the proper way to code the following scenario? "A term-pregnancy patient presents at the ED with vaginal bleeding. The physician rules out rupture of membranes, and sends the patient home. She delivers the next day."

Missouri Subscriber

Answer: First and most important, you'll need to choose the appropriate ED E/M service from the 99281-99285 series based on the chart documentation.

Depending on the workup provided, many pregnancy-associated cases are considered high risk. In this case, you would report the vaginal bleeding and link it to 640.0x (Threatened abortion).