Inpatient Facility Coding & Compliance Alert

Reader Question:

Begin With 99284 for Sickle Cell Patient Admitted Through ED

Question: A patient's husband brought her to the ED because of chest pain; previous records showed she had a history of sickle cell disease. The ED physician ordered multiple labs including a CBC, CMP, and PT/PTT/INR. He also ordered and read/interpreted a two-view chest X-ray. The patient received narcotics and intravenous fluids (Dilaudid, Zofran, and saline hydration) during the course of care (Dilaudid was administered at two separate times). The patient was discharged after her pain was brought under control. Her discharge diagnosis was sickle cell disease with vaso-occlusive crisis and chest pain without evidence of acute chest syndrome. The ED physician documented a detailed history and examination. What should we report for the facility services?North Dakota SubscriberAnswer: You'll need to report several codes to have a complete facility claim:Using a typical facility intervention based model to determine an E/M level, assign 99284 (Administration of infusions or parenteral meds and [...]
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