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ED Coding and Reimbursement Alert

Reader Question:

Use E Codes to Paint Patient Picture

Published on Wed Jun 22, 2011

Question: A patient reports to the ED complaining of pain in his arm, lower back and chest. The ED physician admits the patient to observation status at 8 a.m. Tuesday, where he orders blood tests to check enzyme levels and an electrocardiogram (EKG), which is interpreted by a cardiologist. Following serial examinations, all of the patient's lab work comes back normal. During the course of the blood testing, the patient informs the physician that he had been bench pressing free weights the night before, and he "might have" strained himself. The ED physician discharges the patient at 6 p.m. Tuesday, with a diagnosis of pain caused by heavy lifting. Notes indicate a detailed comprehensive history and examination. Should I include the three ICD-9 codes for the patient's pain as well as an E code? Or just the E code?Minnesota SubscriberAnswer: You should include four ICD-9 codes on this claim, both [...]
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