ED Coding and Reimbursement Alert

READER QUESTIONS:

Ear Wick Won't Warrant Procedure Code

Question: A 25-year-old male patient reports to the ED complaining of right ear pain. The ear is oozing a purulent yellow fluid that has a foul odor. The ED physician diagnoses acute suppurative otitis media and inserts an ear wick soaked in antibiotics into the patient's ear. Is there a code for this procedure? Illinois Subscriber Answer: The only way to capture a physician's effort when inserting an ear wick is an E/M code. So go back and check the notes and choose the appropriate level E/M code -- most likely 99283 (Emergency department visit for the evaluation and management of a patient, which requires these 3 key components: an expanded problem focused history; an expanded problem focused examination; and medical decision making of moderate complexity ...) -- with 382.00 (Acute suppurative otitis media without spontaneous rupture of ear drum) appended to represent the patient's condition.
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