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ED Coding and Reimbursement Alert

Reader Questions:

Leave Dental Codes Off Your ED Claim

Published on Thu May 19, 2011

Question: I have a puzzling claim in front of me. Notes indicate a patient reports to the ED after falling out of bed onto his face. He was vomiting and complaining of intense pain from a headache that he rated as 10 on a 10-point pain scale. The encounter notes indicate that the physician: "Ordered CT scan, Subluxed left front tooth pushed back into place."Amalgam made from dental kit, rolled to a doughy consistency then applied over the frontal teeth area splinted in a mouth-guard fashion with 2 adjacent teeth on each side.Amalgam allowed to dry." Is this a 21085 scenario?Kentucky SubscriberAnswer: Probably not. Even if the physician performed a 21085 (Impression and custom preparation; oral surgical splint) service, you'll have trouble getting paid for a dental code in the ED.Best bet: Roll it into the overall ED E/M work and choose the appropriate ED E/M code. So if the [...]
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