ED Coding and Reimbursement Alert

ED Coding And Reimbursement Alert - 1999; Volume 2 Number 12

Correct Payment for ECG Interpretations Requires Accurate Documentation, Code Assignment
When a patient with a potential cardiac problem is examined in the emergency department (E... Read more

HCFA Rule for Billing for X-ray And ECG Interpretations
Getting paid for electrocardiogram (ECG) and x-ray interpretations has always been a probl... Read more

Special Documentation Required When Physicians Supervise Residents in Teaching Setting
In teaching hospitals (hospitals with graduate medical residency programs), emergency depa... Read more

Objectives for Addressing the Inspector Generals Work Plan
By Caral Edelberg, CPCConsulting Editor, ED Coding AlertPresident, Medical Management Reso... Read more

Reader Question:
Distinction Between Emergency Room and Intermed Visits
Question: I am leading an emergency room Chargemaster committee. At our facility, we have ... Read more

Reader Question:
Billing for PA Services
Question: Can we bill MD charges for physician assisstant (PA) services in the ED if the d... Read more

ED Coding And Reimbursement Alert - 1999; Volume 2 Number 11

Educate Physicians to Avoid Downcoding Level 5 Services to 99284 and Losing Reimbursement
In the emergency department, complex illnesses and serious, sometimes life-threatening, in... Read more

Coding Clinic:
Outpatient Diagnosis Coding Guidelines Haven't Kept Up with Reality of ED Practice
By Caral Edelberg, CPCECA Consulting EditorPresident, Medical Management Resources Inc, Ja... Read more

Policies for Charging Visits from Inmates, Arrested Suspects
Emergency departments should make prior arrangements to alleviate the problem of coding fo... Read more

Reader Question:
Suture Removal
Question: When we suture a patient in the emergency center, we encourage them to follow up... Read more

Reader Question:
Fluid Infusions
Question: My question concerns 90780 (IV infusion). Can you bill for an IV bolus of fluid ... Read more

Reader Question:
E/M Level and a Starred Procedure
Question: Is the examination of the affected area in a starred procedure included in the p... Read more

Reader Question:
Splint Application
Question: Must the doctor personally apply the splint during treatment of a fracture if th... Read more

ED Coding And Reimbursement Alert - 1999; Volume 2 Number 10

Understanding Treatment is Key to Correct Coding for Repair of Fractures and Dislocations
The first issue of ED Coding Alert (December 1998) covered the correct way to report ED ph... Read more

Understanding the Terminology:
Open vs. Closed Fracture
Some coders confuse the indication of an open or closed fracture to mean that the treatmen... Read more

Base E/M Code Assignment on the Level of MDM to Ensure Accurate Reporting
When most ED physicians look at a medical chart, they use a top down approach: take the hi... Read more

E/M Coding Clinic:
Correctly Reporting 99283 vs. 99284 Means Understanding the History and Physical
Reviewed on May 29, 2015 Latest on Accurate Use of CPT Code... Read more

Reader Question:
Correct Fracture Care Code
Question: Can a fracture care code (CPT) for fracture of vertebral traumatic fracture be u... Read more

Reader Question:
E/M and Suture Code
Question: Should I be coding an E/M code and a suture code (12001*, etc.) on the physician... Read more

ED Coding And Reimbursement Alert - 1999; Volume 2 Number 9

How to Catch the Most Commonly Missed Charges in the ED
Few healthcare providers are in more of a reimbursement crunch than emergency physicians: ... Read more

E/M Coding Clinic:
Medical Decision Making Level Determines Difference Between 99282 and 99283
Editors Note: This is the second installment in a series on reporting emergency service ... Read more

Use Caution When Reporting Nursing Procedures on the ED Physician's Bill
Nurses often perform minor procedures in the Emergency Department under the supervision of... Read more

Reader Question:
Using Wound Exploration Codes
Question: Is it appropriate to code for removal of multiple foreign bodies in a penetratin... Read more

ED Coding And Reimbursement Alert - 1999; Volume 2 Number 8

To Bill or Not To Bill:
Coding for Ambulance and EMS Direction
An ambulance from your hospital responds to a report of an automobile accident. The ED ph... Read more

Keep Hospitals and Patients Happy:
Pay Attention to ED Professional Fees to Attract Managed Care Contracts
Keep Hospitals and Patients Happy:Pay Attention to ED Professional Fees to Attract Managed... Read more

Establish an RVS-based Fee Schedule to Ensure Appropriate, Competitive
So, you know you need a fee schedule that keeps you competitive with other emergency physi... Read more

E/M Coding Clinic:
Get Paid for Many Low-level ED Services with Code 99281
Editors Note: One of the most complicated duties for an emergency medicine coder is re... Read more

ED Coding And Reimbursement Alert - 1999; Volume 2 Number 7

Correct Coding Strategies to Get Paid for Administration and Monitoring of Thrombolytics
The use of a group of drugs known as thrombolytics (tPA, Streptokinase, Retivase, etc.) ar... Read more

Case Study:
Patient with Multiple Orthopedic Injuries Evaluated and Treated by the ED Physician
by Caral Edelberg,CPCConsulting Editor Coders are frequently challenged to code for orthop... Read more

Patient Medical Record
History of Present Illness (HPI): The patient is a 51-year-old female who fell down six st... Read more

Coding for AMA and LWBS Patients:
Charge for the Services Provided When Patients Leave the ED Against Medical Advice
Unlike physician offices and hospitals, emergency departments see patients with a variet... Read more

Reader Question:
Coding Drug Reactions
Question: We recently had a patient in our ED with an insulin reaction. I have been taught... Read more

ED Coding And Reimbursement Alert - 1999; Volume 2 Number 6

Emergency ICD-9-CM:
Coding Signs and Symptoms in the ED to Justify Diagnosis Tests, Services
Its a common diagnosis coding dilemma in EDs across the country: A patient comes in comp... Read more

Use E Codes to Establish Medical Necessity, Fully Document Accidents and Injuries
When reporting accidental injuries, poisonings and late affects of injuries that are evalu... Read more

Update on Conscious Sedation:
When Should You Report an E/M Level or Anesthesia Code
In the March issue of ED Coding Alert we covered the reporting of conscious sedation per... Read more

Set Up Internal Log to Track Payer-Specific Coding Policies
Many ED physician groups staff the emergency departments at different hospitals, and see p... Read more

Perspective on the Forthcoming APC Payment Systems
by Andrea Clark, RRA, CCS, CPC-HEditors note: The April issue of ED Coding Alert contained... Read more

Reader Question:
Coding CPR and Critical Care
Question: Can cardiopulmonary resuscitation (CPR) be coded in addition to critical care? ... Read more

Reader Question:
Coding for an External Jugular Line
Question: Is an external jugular line considered a central line by CPT? ECA Subscribe... Read more

Reader Question:
Can You Bill Slit-Lamp Eye Exam Separately?
Question: Can use of a slit-lamp exam for eye injuries be coded separately from an E/M cod... Read more

ED Coding And Reimbursement Alert - 1999; Volume 2 Number 5

Correctly Report PA Services in the ED:
"Incident To" Does Not Apply
Busy EDs across the country rely heavily on physician assistants (PAs). Under the supervis... Read more

ED Coder Roles Broaden With Reduction in RVU Values for Emergency E/M Levels
by Caral Edelberg, CPCConsulting EditorIn many of todays EDs, hospital medical records dep... Read more

How Will Shift to APCs Affect ED Professional Coding and Reimbursement?
In the last issue of ED Coding Alert we covered the initial preparations hospital informat... Read more

Reader Question:
Getting Paid for Dermabond
Question: How should we code and get reimbursed for use of Dermabond? Our cost for this is... Read more

Reader Question:
Documentation for Teaching Physicians
Question: When seeing a Medicare patient, does the history of present illness (HPI) have t... Read more

ED Coding And Reimbursement Alert - 1999; Volume 2 Number 4

Understand the Difference Between Facility Coding and Professional Coding to Resolve Payer Conflicts
Although they are coding for the same ED visits, hospital information coders and emergen... Read more

How Will Shift to APCs Affect ED Professional Coding and Reimbursement?
The good news for emergency group professional coders is that the proposed Medicare APCs... Read more

Maximize Use of Observation Codes to Get Paid for Continuous ED Care
Patients often present to the ED with signs and symptoms that indicate a possibly seriou... Read more

How to Choose the Right E/M Codes to Use in Urgent Care/Fast Track Centers
In the January issue of ED Coding Alert, we covered the issue of coding for E/M services... Read more

RVUs for Emergency Service, Office/Outpatient New and Established Codes
The chart below can be used to compare the relative value units for office/outpatient E/... Read more

ED Coding And Reimbursement Alert - 1999; Volume 2 Number 3

Correctly Code for Conscious Sedation in the ED
When performing delicate and painful procedures on children, the elderly, and some other a... Read more

Case Study:
Consultation, Multiple Procedures, and Diagnostic Testing in Addition to the E/M Service
One of the most common challenges to the ED coder is identifying the correct evaluation an... Read more

Modifier 25 Continued:
Billing an E/M visit and a Starred Surgical Procedure
In the February issue of ECA (pages 9-10), we covered billing for an evaluation and manage... Read more

Reader Question
Question: Is it appropriate to bill pulse oximetry (94760-94761) in addition to the evalua... Read more

ED Coding And Reimbursement Alert - 1999; Volume 2 Number 2

Use Modifier -25 to Get Paid for an Emergency E/M Service and a Procedure
In the emergency department, there are no established patients. Thats why the ED services ... Read more

Case Study:
Coding for a Patient with Multiple Injuries Without Sufficient Documentation of Procedures
by Caral EdelbergECA Consulting EditorEditors Note: In this issue of ED Coding Alert, we i... Read more

Independent ED Physician's Survival Guide to Medicare Reassignment Prohibitions
Editors Note: Although ECAs primary focus is on emergency coding and documentation, we als... Read more

Reader Question:
Billing an E/M addition to Fracture Care
Editors Note: The coding advice this month has been provided by Susan Stradley, CPC, CCS-P... Read more

Reader Question:
Billing for Observation Care Where Consulting with Non-Physician
Question: If you have a patient that presents to the ED with suicidal tendencies and the E... Read more

ED Coding And Reimbursement Alert - 1999; Volume 2 Number 1

Improve Utilization of Critical Care Codes to Increase Reimbursement for Emergency Services
Many ED groups may be missing out on a significant amount of revenue because they are unde... Read more

Correctly Apply 99285 Acuity Caveat to Optimize E/M Coding
Latest on Accurate Usage of CPT Code 99285 from Codify's ... Read more

Pitfalls in Coding and Billing for Urgent Care Centers
To become more attractive to managed care payersand to compete with private clinicsmany ho... Read more

Tailor ED Coding Policies and Procedures to Meet OIG Compliance Plan Guidance
by Caral EdelbergEDCA Consulting Editor PresidentMedical Management Resources, Inc.Jackson... Read more

Available Years: 1999 1998