ED Coding and Reimbursement Alert

Question: Our ED physician visits an admitted patient dying of cancer and declares that the patient is dead. The ED physician tells the family the news, and the nurse provides them with counseling and information they may need. Should I send the family yet another bill for the ED physician confirming the patient, or is the physician's work courtesy?

Florida Subscriber

Answer: You should check with your department. Most EDs do not charge for this service. You could report subsequent hospital care (99231-99233), which includes reviewing the medical record, the results of diagnostic studies and changes in the patient's status since the last physician assessment. These E/M services require the usual history, physical examination and medical decision-making. You should probably refrain from using these codes, however, and assume that you would not report the service for reimbursement unless directed otherwise. You may have a hard time justifying the medical necessity of the service to a patient who is dead.