ED Coding and Reimbursement Alert
Report ED E/M for Help With Delivery
Question: How should I report a scenario in which the emergency department physician helps an obstetrician/gynecologist in the vaginal delivery of an infant in the emergency department? What kinds of documentation should I include to strengthen this claim? Answer: First, you must document medical necessity for the assistance at delivery. However, rather than reporting the delivery code and appending modifier -82 (Assistant surgeon [when qualified resident surgeon not available]), your cleanest coding option may be to report one of the ED E/M codes: Depending on the circumstances and the documentation provided, you could bill both an ED E/M and the appropriate delivery code. -- Reader Questions and You Be the Coder were reviewed by Michael A. Granovsky, MD, CPC, FACEP, vice president of coding at Medical Reimbursement Systems in Stoneham, Mass.
West Virginia Subscriber
99282 - ... an expanded problem-focused history, an expanded problem- focused examination, and medical decision-making of low complexity
99283 - ... an expanded problem-focused history, an expanded problem- focused examination, and medical decision-making of moderate complexity
99284 - ... a detailed history, a detailed examination, and medical decision- making of moderate complexity
99285 - ... within the constraints imposed by the urgency of the patient's clinical condition and/or mental status: a comprehensive history, a comprehensive examination, and medical decision-making of high complexity.
ED Coding and Reimbursement Alert
- Patch Up Holes in Your Laceration Coding
These 3 rules can save you $50 per cut Reimbursement for laceration repairs could be [...] - See Through Chest X-Ray Troubles
Follow these tips to 'x' out denials Your emergency department (ED) performs chest x-rays regularly, [...] - Test Your Laceration Coding Know-How
Determine how you would code these laceration repairs If you're still unsure about how to [...] - Watch for 5 Complications When Coding Diabetes
Don't get tripped up on multiple conditions Each time you choose a fourth and fifth [...] - You Be The Coder:
Report Layer Closure Separately
Question: Our physician saw a patient with lesions on his face and cheek. He excised [...] - Reader Question:
How to Report Cerumen Removal
Question: How should I report cerumen removal, and can I ever report a separate evaluation [...] - Reader Question:
Attach -GY, -GZ to Speed Denials
Question: What are modifiers -GY and -GZ, and how should I use them?
Oregon Subscriber
Answer: The [...] - Reader Question:
Use Modifier -24 for Unrelated E/M
Question: A patient reported to the emergency department three weeks ago for pain in his [...] - Reader Question:
Cover Your Bases With Poisoning
Question: A patient who had apparently attempted suicide by ingesting multiple medications presented to the [...] - Reader Question:
Report ED E/M for Help With Delivery
Question: How should I report a scenario in which the emergency department physician helps an [...]
