ED Coding and Reimbursement Alert
Use Modifier on 'Involuntary' Services
Question: A patient presents to the ED with a police escort. An officer tells the front desk that the patient is there for a court-ordered drug test for cocaine. How should I code this encounter? Texas Subscriber Answer: When the patient is ordered to submit to a procedure or service, attach modifier 32 (Mandated services) to the CPT code. This lets the payer know that the service is "related to mandated consultation and/or related services (e.g., third-party payer, governmental, legislative or regulatory requirement)," according to the CPT 2008 manual. On the claim, report the following: - 80100 (Drug screen, qualitative; multiple drug classes chromatographic method, each procedure) for the screening - 80102 (Drug confirmation, each procedure) for the confirmation - modifier 32 linked to 80100 and 80102 to show that the tests were ordered. Note: You may also wish to append V70.4 (Examination for medicolegal reasons) or V62.5 (Persons encountering health services; legal circumstances) to the screening codes.
ED Coding and Reimbursement Alert
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Ulnar Shaft Splinting
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Use Modifier on 'Involuntary' Services
Question: A patient presents to the ED with a police escort. An officer tells the [...] - Reader Questions:
Check Patient Age on Catheter Code
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If Physician Makes No Incision, Opt for E/M
Question: A patient presents to the ED with shards of glass from a shattered light [...] - Reader Questions:
When Physician Performs Both, E/M Trumps Ventilator Management
Question: I have a tough coding choice to make. The physician performs initial-day ventilation management [...]
