ED Coding and Reimbursement Alert

Question: A patient came to the ED with a nosebleed following an accidental head-butt by his brother while they were wrestling. The ED physician had the patient hold an ice pack to his nose while the physician asked the nurse to bring nasal packing materials to the patient’s bedside. When the physician returned to check on the patient, the bleeding had subsided and packing was not necessary. Which code should we report?

Florida Subscriber

Answer: Although most EDs are accustomed to reporting 30901 (Control nasal hemorrhage, anterior, simple [limited cautery and/or packing] any method) or 30903 (Control nasal hemorrhage, anterior, complex [extensive cautery and/ or packing] any method) for most epistaxis patients, those codes are not necessary in this situation.

If simple procedures like ice and pressure succeed by themselves, an E/M code is appropriate. Therefore, the most applicable code should be selected from the 99281-99285 range based on the documentation of the encounter.