ED Coding and Reimbursement Alert

Question: We are a very busy ED, and several physicians here do not speak Spanish. We use our front office staff, who are not professional licensed translators, to translate when necessary. When a physician uses one of them to interpret during a visit, can we code a higher level of care?

Virginia Subscriber

Answer: Yes, you can. Because there is no specific code for interpretive services, no rules exist regarding who counts as an interpreter. The physician may instead select a higher-level service based on:

- the history and medical decision-making's added complexity. Additional history questions relating to cultural and family issues, as well as more complex medical decision-making related to the same cultural, family and language issues could justify using a higher-level office visit code.

- time. You could use time to support a higher-level service provided counseling and/or coordination of care dominates (more than 50 percent of the time) the face-to-face encounter.

-- Reader Questions and You Be the Coder reviewed by Michael A. Granovsky, MD, CPC, FACEP, president of MRSI, an ED coding and billing company in Woburn, Mass.