ED Coding and Reimbursement Alert

Question: EMS brought a patient with a known seizure disorder to the ED. The patient was postictal after suffering a seizure at home. A test revealed the patient's Dilantin level was 0. The physician infused one gram of Dilantin over 30 minutes to prevent further seizures. The patient had another brief seizure, which the physician treated with an Ativan IV push. The physician then documented several assessments and monitored the patient for complications. What series of codes should I report for this encounter?

Indiana Subscriber
 
Answer: To report this scenario, you-ll need to dip into the new codes for therapeutic, prophylactic and diagnostic injections and infusions.
 
On the claim, you should:

 - report 90765 (Intravenous infusion, for therapy, prophylaxis, or diagnosis [specify substance or drug]; initial, up to 1 hour) for the Dilantin infusion.

 - report +90775 (... each additional sequential intravenous push of a new substance/drug [list separately in addition to code for primary procedure]]) for the Ativan injection.

 - attach ICD-9 780.39 (Other convulsions) to 90765 and 90775 to represent the patient's seizure.