Wiki ER Facility Coding

[nyyankees]

Curious - what type of resource chart some facility coders use. We use something as simple as nurse + doctor visit = 99282 and something as complex as a chart of about 50 possibilities (i.e. repeat vitals, # of nurse visits, neuro assessment) that have anywhere from 5-30 points.

I have felt that the simpler the better. Thanks.

 

[mitchellde]

we use a point system for all levels of visit.. it is totally objective and easy to follow. 0-4 points is a no visit 5-10 is a level 1 11-20 a 2 and so on.each type of activity that cannot be coded with with a CPT code has a point value of 5, 10, 15, or 20 points, such as vitals are 5 points, continuous vitals are 10 points. transport to radiology is 5 points and so on.

 

[Ggs9006]

Facility ED Levels

You could review the ACEP model. It is a recommended guide that could be used for determining the facility coding levels. I hope this helps.

 

[nyyankees]

Thank you. Our resource chart are anything but simple. It takes our ER coders 1 hour to code 4 charts. Our ER sees 200-300 patients per day.

 

[jimbo1231]

Facility Levels

Well CMS tried to simplify your coding by reducing the 5 levels to 1, but that has been delayed. If my math is right, you need 6-7 full time coders to code the 200 charts perday at your facility. That is crazy expensive. As Michelle mentioned there are reasonbly user friendly point systems out there, ACEP as mentioned and some other methods. There have been a few articles in Cutting Edge about ED Facility coding including a two parter I wrote in 2010. It does include examples of several methods.

Jim S.