ED Coding and Reimbursement Alert

Tip: CC codes carry no caveat constrictions.When you spot an encounter form that's a candidate for ED caveat coding, be sure you check if the patient received critical care, which pays out at a higher rate. Check out this quick critical care coding seminar, and ethically recoup almost $50 more each time you spot 99291 opportunities for patients who qualify for the caveat.Check If Caveat Patients Got CCPatients who qualify for the ED caveat often require critical care, confirms Michael Lemanski, MD, ED billing director at Baystate Medical Center in Springfield, Mass. "The caveat is used primarily for patients with altered mental status [AMS]," he says. " Although, a patient may be somnolent from something as simple as alcohol ingestion, many patients where the HPI is truly unobtainable have a life-threatening condition requiring critical care."And there is a significant difference in payout between 99285 (Emergency department visit for the evaluation [...]