ED Coding and Reimbursement Alert

Question: Encounter notes state that the physician treats a patient suffering from exudative pleural effusion. The physician performs a level-five ED E/M, and inserts a needle in the patient's chest cavity to remove fluid. I reported 99285-25 and 32551 and received a denial -- what did I do wrong?Minnesota SubscriberAnswer: You selected the wrong procedure code for your physician's actions. When you re-submit the claim, report the following:32421 (Thoracentesis, puncture of pleural cavity for aspiration, initial or subsequent) for the needle insertion99285 (Emergency department visit for the evaluation and management of a patient, which requires these 3 key components within the constraints imposed by the urgency of the patient's clinical condition and/or mental status: a comprehensive history; a comprehensive examination; and medical decision making of high complexity ...) for the E/MModifier 25 (Significant, separately identifiable evaluation and management service on the by the same physician on the same day of the procedure [...]