ED Coding and Reimbursement Alert

Does your chart include the required elements to stand up under audit? If you're getting repeat denials when your ED physician interprets electrocardiograms [EKG], it's time to stop and ask yourself some critical questions, including whether the documentation meets Medicare's definition of interpretation and whether the notes clearly identify which ED provider did the interpreting and why the EKG was ordered. Reality: One of the most frequently reported non-E/M services in the emergency department is for EKG interpretation; unfortunately, these codes are also among the most frequently contested services as well. E/M link: A review of a previously interpreted EKG has value in E/M code Medical Decision Making, but in a totally different way from being separately billable. Follow these tips from Caral Edelberg, CPC, CPMA, CAC, CCS-P, CHC, President of Edelberg Compliance Associates in Baton Rouge, Louisiana, to make sure you are meeting the required documentation for appropriate payment. [...]