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ED Coding and Reimbursement Alert

Reader Questions:

E/M Code Keys Your PQRI Claim

Published on Mon Jul 26, 2010

Question: Our ED wants to report on the physician quality reporting initiative (PQRI) measure 92: Acute Otitis Externa -- Pain Assessment. A 66-year-old patient reports to the ED saying he has a severe right earache; he says it's been going on for three days and rates the pain at 8 on a scale of 10; he also complains of itching and hearing loss in the affected ear. The physician performs an expanded problem focused history and exam, noting "dry, hard cerumen/R canal blocking tympanic membrane." The physician diagnoses supprative otitis media along with impacted cerumen; notes reflect moderate medical decision making. Using saline irrigation and curettes, the physician removes the cerumen and sends the patient home.Can I report the PQRI code?Florida SubscriberAnswer: No, you can not report the PQRI code, as the ED E/Ms are not part of the denominator for the PQRI measure 92. To report this measure, you need: [...]
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