ED Coding and Reimbursement Alert
Consider Work Done With Subsequent Care Codes
Question: Our emergency department physician answered a code blue to a patient's room, and documented a history of present illness, review of systems, histories, and a physical exam. Should I report subsequent hospital care for this service? How should I code for an ED doctor who, when called to the floor, only ordered tests and observed what the nursing staff did? Answer: Your best choice for this scenario is to report one of these codes for subsequent hospital care:
Iowa Subscriber
If the physician documentation does not support an evaluation and management service (99281-99285) and the physician didn't perform any separately billable services, you have nothing to report in a claim.
Typically, the physician responds to these kinds of calls as a service to the hospital or the medical staff. Of course, if your physician did provide legitimate E/M services, you should certainly report them.
ED Coding and Reimbursement Alert
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Consider Work Done With Subsequent Care Codes
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Append -52 for Extra Infusion Time
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