ED Coding and Reimbursement Alert

Question: A patient reports to the ED with a blister on her right finger. During an expanded problem focused history and examination, the physician determines that the patient's blister is "superficial, uncomplicated and already draining." The physician applies antibiotic ointment and dry bandages for comfort. Can I report an incision and drainage (I&D) code for this encounter?

Nebraska Subscriber

Answer: You are likely to get denied on your claims for I&D services if the physician did not actually perform an I&D of any type. On the claim, report the following:

99282 (Emergency department visit for the evaluation and management of a patient, which requires these 3 key components: an expanded problem focused history; an expanded problem focused examination; medical decision making of low complexity ...) for the E/M

915.2 (Blister of fingers without mention of infection) appended to 99282 to represent the patient's blister.