ED Coding and Reimbursement Alert

Question: We recently received a denial from Medicare for an emergency department visit because the report stated, "date of death precedes this visit." How should we handle this?


Washington Subscriber


Answer: How you should handle it depends on the specifics of the situation. You have three possibilities here:

The date of death on record preceded the recorded emergency department visit date, the date of death was equal to the patient's date of service, or the patient is, in fact, alive, and Medicare is basing its denial on an error in the Social Security database.

In the first situation - the date of death preceded the date of service in your records - you should check them to make sure you billed the appropriate date of service. If not, you can easily correct this error.

If the date of death was the same as the patient's date of service, you should appeal the denial with a copy of the ED notes that state the physician was treating the patient, but the patient subsequently died (either in the ED or later that day).

If the patient is still alive, you need to inform the patient of the situation, and talk to her (and possibly her family) about correcting the Social Security records.