ED Coding and Reimbursement Alert

Question: How should I code the emergency department professional fee for the administration of intravenous (IV) medications, intramuscular (IM) medication and blood transfusions? What documentation is required? Arizona Subscriber Answer: A nurse typically performs IV or IM administration or injection of medications or blood products. In the hospital setting, services performed by ancillary staff are covered within the facility fee, not the professional fee, and should be billed by the hospital. If the patient's condition is severe, the physician's presence is required when the medication is delivered. (See the article on thrombolytics in the May 2002 issue, page 33, for more details.) The code for administration of IM injections in the physician's presence is 90782 (Therapeutic, prophylactic or diagnostic injection [specify material injected]; subcutaneous or intramuscular). Code 90782 may not be paid unless specific documentation detailing the necessity of the physician's service is included with the claim.