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ED Coding and Reimbursement Alert

READER QUESTIONS:

Code Physician Involvement, Supervision Differently

Published on Sun Sep 06, 2009

Question: A 35-year-old patient reports to the ED having a spontaneous abortion. The fetus, approximately 7 cm, was expelled but still attached by the partially severed umbilical cord. The ED physician gently massages the mother's abdomen, and removes the placenta. After ensuring the patient was not experiencing any complications, the physician releases the patient. Is the placenta delivery part of the E/M service, or can I code it separately? Kansas Subscriber Answer: From a technical coding perspective, if the ED physician manually removes the placenta, you could code it separately. If you have evidence of the physician's involvement, report the following: • 59414 (Delivery of placenta [separate procedure]) for the placenta delivery • the appropriate ED E/M code, such as 99284 (Emergency department visit for the evaluation and management of a patient, which requires these 3 key components: a detailed history; a detailed examination; and medical decision making of moderate [...]
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