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ED Coding and Reimbursement Alert

Reader Questions:

Use This Critical Info to Key to TP E/Ms

Published on Sat Jun 05, 2010

Question:One of our ED physicians and a resident performed a level-three ED E/M service for a 63-year-old patient with complaints of headache and dizziness, which was also the patient's final diagnosis. The patient was sent home with a prescription for Tylenol with codeine and instructed to check in with her primary care physician (PCP) should the headaches persist for more than four more days. Are we allowed to bill this visit under teaching physician (TP) rules?New Mexico SubscriberAnswer:You'll have to go back and check the encounter notes to make sure the visit meets Medicare's TP reporting rules. If it does pass Medicare muster, you'd report the following:99283 (Emergency department visit for the evaluation and management of a patient, which requires these 3 key components: an expanded problem focused history; an expanded problem focused examination; and medical decision making of moderate complexity ...) for the E/Mmodifier GC (This service has been [...]
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