ED Coding and Reimbursement Alert

Question: When ED physicians order antibiotics, cardiac drugs, Benadryl for allergic reactions, and pain medications that can be considered diagnostic or therapeutic, is it appropriate to bill for these drugs with 90784? The hospital supplies the medications in the ED, but there does not seem to be any stated or implied requirement that the physician ordering the drugs be the purchaser of the drugs.


Connecticut Subscriber

Answer: In the emergency department setting, the hospital is supplying the medications - so the professional billing would be for the drug administration only, because that is the service the ED physician is providing. On the professional side, you would report the injections separately using CPT code 90784 (Therapeutic, prophylactic or diagnostic injection [specify material injected]; intravenous).

Beware: Some payers may not consider these as physician services, so be prepared for possible denials with these claims.