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ED Coding and Reimbursement Alert

Reader Questions:

Use 3 Code-Pairs to Ace This X-Ray Claim

Published on Fri Mar 26, 2010

Question: A 38-year-old patient reports to the ED with complaints of wheezing, coughing, and trouble catching her breath. After the nonphysician practitioner (NPP) performs a problem focused history, the ED physician performs a detailed history and exam and discovers focal ronchi. The physician orders a two-view chest x-ray to check for upper respiratory infection (UR) The chest x-ray results reveal acute URI, and the ronchi clears up upon reevaluation. The patient is treated with antibiotics. How should I code this scenario? Kansas Subscriber Answer: You'll submit two of each for this claim:  CPT codes, modifiers, and ICD-9 codes. On the claim, report the following: 71020 (Radiologic examination, chest, 2 views,frontal and lateral;) for the x-ray Modifier 26 (Professional component) appended 71020 to show that you are coding for the physician's services only 99284 (Emergency department visit for the evaluation and management of a patient, which requires these 3 key components: [...]
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