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ED Coding and Reimbursement Alert

Be the First to the Finish Line With EKG and X-Ray Interpretations
The most effective way to code EKG and x-ray interpretations for the emergency p... Read more
Dispel Coding Myths About EKG and X-Ray Interpretations
To gain proper reimbursement for EKG and X-ray interpretations, you'll need to separat... Read more
Are You Underplaying the Critical Care Codes?
You don't need a medical disaster to report codes for critical care in the emergency d... Read more
New Pediatric Critical Care Codes and 2003 Changes
Changes in pediatric codes are small incidentals for the emergency department, but t... Read more
Refresher Course on Critical Care Codes and Bundles
Critical care codes have changed frequently in the past 10 years, so make sure you'r... Read more
Medicare News You Can Use:
Changes in NPP Rules Increase Reimbursement
Your ED physicians no longer sacrifice full reimbursement when they recruit nonphysi... Read more
Reader Questions:
Dislocation and Fracture Care
Question: A patient presents with a fracture of the ankle. It was severe enough to c... Read more
Reader Questions:
Ear Wick
Question: One of our physicians inserted an ear wick saturated with an antibiotic into... Read more
You Be the Coder:
EKG and X-Ray Interpretations
Test your coding knowledge. Determine how you would code this situation before l... Read more
Deliver Clean Pregnancy Ultrasound Claims
It's a common emergency department scenario: The physician orders an ultrasoun... Read more
Auditor's Worksheet Designed to Help, Not Hamper E/M Coding
" The Marshfield Clinic Auditor's Worksheet can help you avoid evaluation and managemen... Read more
Modify the PATH to Proper Reimbursement With -GC
The straight and narrow path is the only way to appropriate reimbursement. ED code... Read more
CCI Edits
CMS, along with the National Technical Information Service (NTIS), has released ... Read more
READER QUESTION:
EKG Interpretation
Question: How do AMA and Medicare guidelines differ for coding an emergency ph... Read more
READER QUESTION:
Conscious Sedation Denial
Question: I submitted a claim for a shoulder dislocation using codes 23650 (Closed... Read more
READER QUESTION:
Paronychia I&D With E/M
Question: A father brought his son to the emergency department for a swollen finger ... Read more
READER QUESTION:
Procedures Plus E/M Services
Question: One of our nurses claims I can't use an E/M service code with procedure co... Read more
You Be the Coder:
Bilateral Chest Tubes
Test your coding knowledge. Determine how you would code this situation before looki... Read more
Catch the Ultrasound Reimbursement Wave
Some ultrasound techniques are still new enough to emergency medicine ... Read more
Seek Out Signs and Symptoms to Maximize Reimbursement
Signs and symptoms codes can help classify a visit when no distinct diagnosis ca... Read more
Coders Have One Profession, Two Sets of Guidelines
Nowhere is the debate over billing for signs and symptoms more apparent than in th... Read more
Guarantee ED Specialists Their Pay With the Acuity Caveat
Coding for patients with life-threatening illnesses and injuries can require less st... Read more
Reader Question:
Ingrown Nails
Question: I would like to know which CPT code to use for removal of an ingrown nail,... Read more
Reader Question:
Stick With Correct Dermabond Code
Question: In our ED, we recently saw a Blue Cross patient who had Dermabond applied ... Read more
Reader Question:
Simple and Complex Abscesses
Question: I frequently incise and drain abscesses, and wonder, from a billing poin... Read more
Reader Question:
Conscious Sedation by Residents
Question: Can a resident perform conscious sedation (99141)? Does the teaching phy... Read more
You Be the Coder:
Non-Emergency E/M Codes
Test your coding knowledge. Determine how you would code this situation before looki... Read more
Three Easy Steps to Diagnosis Coding for Electrocardiography
To ensure proper diagnosis coding for electrocardiography, you need to remember tw... Read more
Use After-Hours Codes in the ED at Your Own Peril
Although some coders argue that submitting for after-hours work in the ED is contrar... Read more
Coding Resident Services From Non-ED Specialties
Even after a coder in a teaching hospital learns the basics of Medicare's guidelines f... Read more
Reader Question:
Comprehensive Exams
Question: I'm looking for clarification of the exam portion of the 1995 E/M guidelines... Read more
Reader Question:
Trauma Arrest Modifiers
Question: For a trauma arrest in which the emergency physician placed a left subclav... Read more
Reader Question:
Pulse Ox Interpretation
Question: I frequently get asked about coding 94760 (Noninvasive ear or pulse oximet... Read more
Reader Question:
History of Present Illness
Question: Can the history of present illness (HPI) elements be obtained from the nurse... Read more
You Be the Coder:
EKG Billing and Coding
Test your coding knowledge. Determine how you would code this situation before looking a... Read more
Cast Away Your Fracture Coding Confusion
" Fracture care is one of the most common procedures performed in the ED, yet many EDs ba... Read more
Use Modifiers to Sort Fracture Care Management
Because orthopedic codes can seem like the whale that swallowed Jonah encompassing bo... Read more
Seeing Double in the ED:
Assigning Multiple E/M Codes on the Same Day
The rule of thumb for assigning E/M codes in the ED one service per physician, per ... Read more
Clarification of Resident Services
An article titled "Strict Rules Determine Payment for Resident Services" in the May ed... Read more
Reader Question:
Fees for IVs
Question: How should I code the emergency department professional fee for the administ... Read more
Reader Question:
Epicondyle Fracture
Question: I am coding a radiology report written by our ED physician that says, "Poste... Read more
Caution:
Verify Medical Necessity Before Reporting Common Codes
Because Medicare's "incident-to" rules don't apply in a hospital setting, coders who... Read more
Tie Up Suture Coding Loose Ends for Optimal Pay-Up
Laceration repair is invariably high on every ED coder's list of top-10 chall... Read more
Medicare Versus CPT:
Know the Coding Differences
ED practices may leave thousands of dollars on the table each year by applying Medic... Read more
Reader Question:
Abdominal Ultrasound
Question: Our ED physician performed a limited abdominal ultrasound on a patient who c... Read more
Reader Question:
Eye Burn Care
Question: A mother brought in her teen-age son who suffered burns on the eye from sp... Read more
Reader Question:
Catheter Insertion and E/M
Question: A patient presented to the ED complaining of pain during urination. An exam ... Read more
Reader Question:
An Incomplete History
Question: Our ED physician performed an extensive exam on a patient in cardiac arrest ... Read more
Reader Question:
Excessive Ingestion of Prescriptives
Question: A patient with shortness of breath and heart palpitations presented to the E... Read more
You Be the Coder:
Pediatric Hydration and Observation
Test your coding knowledge. Determine how you would code this situation before looking a... Read more
Five Pointers on How to Optimize Reporting Nonphysician Practitioner Services
Although Medicare and other payers may allow payment for specific services provided by... Read more
Modifiers Unraveled:
Use Modifiers -52,-53 to Indicate Incomplete Procedure
When a procedure is terminated due to patient intoleran... Read more
Reader Question:
Suicide Observation
Question: A patient arrives in the ED with suicidal tendencies. Our physician admits t... Read more
Reader Question:
Insulin Reaction
Question: We recently had a patient in our ED with an insulin reaction. I am not sure ... Read more
Reader Question:
Impacted Cerumen
Question: A young girl was recently brought into the ED with a high fever and difficul... Read more
Reader Question:
Prolonged Services in ED
Question: How should our ED physician receive reimbursement when patients are kept... Read more
You Be the Coder:
Modifiers With Fracture Care
Test your coding knowledge. Determine how you would code this situation before looking... Read more
Coding Alternatives May Allow Thrombolysis Reimbursement to Flow Freely
Thrombolytics, with open blocked vasculature, have been used in the emergency department... Read more
Strict Rules Determine Payment for Resident Services
Because emergency medicine is ripe with learning opportunities, many medical stude... Read more
Clarification:
Report Digital Blocks in Addition to Starred Procedures
An article in the February 2002 issue of Emergency Department Coding Alert prompted re... Read more
Reader Question:
Interpreting Radiology Reports
Question: If an ED physician performs a bladder scan for residual urine and provides a... Read more
Reader Question:
Removal of Retained Tissue
Question: A woman with heavy vaginal bleeding and abdominal cramping presented to the ED... Read more
Reader Question:
Physician-Placed NG Tubes
Question: We have had problems getting paid when our ED doctors place NG tubes. What is ... Read more
Reader Question:
Death of a Patient
Question: One of our patients died before a full EKG was completed. Is the coding differ... Read more
You Be the Coder:
Reduction with Anesthesia
Test your coding knowledge. Determine how you would code this situation before looking... Read more
Communication Is Key When Billing for Current Care Services
Emergency department (ED) physicians occupy a unique position in the healthcare field o... Read more
Audit Worksheet Helps Coders Determine MDM Levels
ED coders must rely heavily on the documentation recorded by the physician and learn h... Read more
Reader Question:
Coding Symptoms or Rule-Out Diagnosis
Question: Our ED physician recently saw a pediatric patient with a very high fever and s... Read more
Reader Question:
Gathering HPI
Question: I am confused about whether the information that nurses gather during triage c... Read more
Reader Question:
Payment for Pulse Oximetry
Question: Is it appropriate for emergency physicians to bill for pulse oximetry? If so, ma... Read more
Reader Question:
Reduction with Anesthesia
Question: An elderly man presented to our ED with a dislocation of the patella. He was i... Read more
Reader Question:
Using -RT/-LT on the Pelvis
Question: Is it appropriate to put RT/LT modifiers on an x-ray of the pelvis? Alaska Subsc... Read more
Reader Question:
Removal of Foreign Body with Fluoroscopy
Question: How should I code for fluoroscopy used to remove a foreign body from a finger?... Read more
You Be the Coder:
Nail Injuries
Test your coding knowledge. Determine how you would code this situation before looking a... Read more
Take Heart:
Rhythm Strips May be Paid in Some Cases
Emergency department (ED) physicians often review and interpret rhythm strips on ... Read more
Alter Your Use of Modifiers and Avoid the Potential for Abuse
Few days pass when professional coders who often code dozens of records in each eight... Read more
How to Clean Up Debridement Coding Issues
In many cases, debridement performed in the emergency department will be included in which... Read more
Reader Question:
Consultations in the ED
Question: Should I use consultation codes (99241-99245) when a family physician sends a pa... Read more
Reader Question:
NPs in the ED
Question: What services can nurse practitioners (NPs) bill for when they treat patients in... Read more
Reader Question:
Nebulizer Treatments
Question: How should I code aerosol breathing treatments provided by the physicians in our... Read more
You Be the Coder:
Slit Lamp Exams
Test your coding knowledge.  Determine how you would code this situation bef... Read more
Wake Up to Differences between Conscious Sedation and Anesthesia Codes
Emergency department coders often say they are in a quandary about how... Read more
Coding Outside the Box Whats in a Global Package
For many emergency department coders, "What comprises a global surgical package?" is t... Read more
News Brief:
CCI Edits Contain No Major Changes
Besides heralding a new year, Jan. 1 also brings a new batch of edits to the Correct Codin... Read more
Reader Question:
Residents in the ED
Question: What are the documentation requirements when an attending physician supervises a... Read more
Reader Question:
Foreign Body Removal
Question: If our ED physicians remove several particles or foreign bodies from a penetra... Read more
Reader Question:
External Jugular Line
Question: Is an external jugular line considered a central line or a central venous-access... Read more
Reader Question:
CPR with Critical Care
Question: Is it appropriate to assign cardiopulmonary resuscitation (CPR) codes in addit... Read more
You Be the Coder:
Using V Codes
Test your coding knowledge.  Determine how you would code this situation before loo... Read more
Dont Get Burned by Overlooking the 16000 Series
Legitimate opportunities for increased ethical revenue are being lost if emergency depar... Read more
New Medicare HCPCS Modifiers
CMS will delete HCPCS modifier -GX (service not covered by Medicare) as of Jan. 1, 2002. T... Read more
Physician Payment Conversion Factor Decreased for 2002
Representatives from CMS explained the decreased conversion factor that will be used t... Read more
CPT 2002 Introduction Contains Major Change
Emergency department coders must pay close attention to language changes in the front ... Read more
Anthrax Coding Report Free on Web
Physicians and other healthcare professionals who provide services to any patients with ac... Read more
Reader Question:
Level-Five ED Visit
Question: Please help me determine the level of E/M code for the following case. A patient... Read more
Reader Question:
Pronouncing Death
Question: Our ED physicians are sometimes called to the hospital to pronounce the death ... Read more
You Be the Coder:
Repeated Unsuccessful Shoulder Reductions
Test your coding knowledge.  Determine how you would code this situation before l... Read more
Available Years:  2002  2001  2000  1999  1998