ED Coding and Reimbursement Alert
Ring in the New Year with a Refresher of Alcohol Related Diagnoses
Make sure you select the right diagnosis code when alcohol is a factor an ED visit The New Year is upon us and with it comes an increase in alcohol-related presentations to the ED. Although many presenting problems are injuries or illnesses to which alcohol was a contributing factor, it may be worth reviewing the various alcohol-related diagnoses that are available and when to apply them in the ED setting. Take a look at some common patient types: 1. Patients who are brought in because they are impaired It is not uncommon for a highly intoxicated person to be brought to the ED by concerned friends, parents, or law enforcement officers because the patient appears to be unresponsive or dangerously intoxicated. First let's consider the patient, for whom no other diagnosis is possible, has come under medical care because of the maladaptive effect of a drug on which he is not dependent, and that he has taken on his own initiative to the detriment of his health or social functioning, such as a New Year's Eve or a Super Bowl party. In this scenario, the patient has no history of alcohol dependency, but appears to have significantly exceeded his limit on this occasion. ICD-9 codes that might apply are: 2. Patients whose condition is caused by long time alcohol abuse The other end of the spectrum is the long time alcohol abuser whose medical problems are directly attributed to that history. Possible presentations include hallucinations, seizures or delirium tremens. These patients may or may not be impaired at the time of their visit. Frequently seen ED presentations can be reported with the following diagnosis codes: Don't forget the V codes Is it time for an Intervention? Consider behavior change intervention codes Sometimes the trip to the ED for an alcohol-related injury becomes an opportunity for a screening and intervention to occur. Consider the patient who fell down the stairs because they were intoxicated or when alcohol appears to have contributed to MVA related injuries. Although a busy ED is not the ideal place for this service, check the chart documentation to see if there is support for reporting the following codes [See ED Coding and Reimbursement Alert, Oct. 2011 Vol. 14, No 10 for more information on this topic]
ED Coding and Reimbursement Alert
- 2012 Physician Fee Schedule:
Prep For ED E/M Coding Adjustments, Telehealth Coverage, and Other Changes
Check these RVU changes to calculate your 2012 payments If you were hoping for a [...] - The 2012 Conversion Factor Remains in Limbo
2011 will conclude with a Medicare Conversion factor (the Medicare payment per RVU) of $33.9764. [...] - 2012 CPT® Errata:
Late Breaking News: Add Subsequent Observation Codes to Prolonged Services Range
Last month's issue of ED Coding and Reimbursement Alert reported on the 2012 CPT® updates [...] - Audit Proof Your History Component Coding Selections:
Here's How
See this advice on using "Non-contributory" to document a ROS of past, family, social history.ED [...] - ICD-9 Coding:
Ring in the New Year with a Refresher of Alcohol Related Diagnoses
Make sure you select the right diagnosis code when alcohol is a factor an ED [...] - You Be the Coder:
Don't Be Shocked; Is This Cardioversion or Defibrillation?
Question: How would you code the following scenario? A78 year-old-male presents to the ED after [...] - Reader Question:
Can two emergency physicians both report critical care?
Question: A critically ill patient was seen by one emergency physician who documented 91 minutes [...] - Reader Question:
Consider Patient Age For Critical Care Transport
Question: Is anyone billing procedure codes for an emergency physician who rides with a patient [...]
