ED Coding and Reimbursement Alert
ICD-9 Code Choice Depends on Apnea's Cause
Question: The ED physician performs a level-two E/M on a patient with sleep issues. The medical record indicates that the patient had obstructive sleep apnea caused by excess weight. Should I use ICD-9 code 780.51 to represent this condition? Minnesota Subscriber Answer: Code 780.51 (Insomnia with sleep apnea, unspecified) is not specific enough for your scenario. Use 780.51 when the physician cannot (or has not yet) determined the cause of the condition. Because the physician noted that excess weight caused the apnea, you should instead choose 327.23 (Obstructive sleep apnea [adult] [pediatric]) as a diagnosis. On the claim, report 99282 (Emergency department visit for the evaluation and management of a patient, which requires these three key components: an expanded problem focused history; an expanded problemfocused examination; medical decision-making of low complexity) and 327.23. Also, include 278.01 (Morbid obesity) as a secondary diagnosis to represent the cause of the patient's obstructive sleep apnea.
ED Coding and Reimbursement Alert
- Heed this Info on Latest Critical Care Updates to File the Cleanest Claims
1 CMS transmittal tough on the ED, but another clears up family counseling rules CMS [...] - Overlapping Time Usually a No-No on Critical Care
Be careful when considering concurrent critical care coding Your ED physician and a different specialty [...] - ICD-9 2009 Update:
Update Cancerous Pleural Fluid, Pneumonia Diagnoses
You can now code pleural effusions based on malignancy The ICD-9 2009 manual will bring [...] - You Be the Coder:
Check Hand or Foot Before Coding FBR
Question: A patient with a splinter reports to the ED. After a level-two E/M, the [...] - Reader Questions:
Heed These Rules on NPP Critical Care
Question: I have heard that nonphysician practitioners (NPP) in the ED can provide critical care [...] - Reader Questions:
ICD-9 Code Choice Depends on Apnea's Cause
Question: The ED physician performs a level-two E/M on a patient with sleep issues. The [...] - Reader Questions:
Freeze at 327.XX ICD-9 Section for Sleep Paralysis
Question: A patient comes to the ED reporting that shortly after waking up in the [...] - Reader Questions:
Modifier 51 Marks Multiple-Surgery Encounters
Question: A patient reports to the ED with two cuts on his right forearm: a [...] - Reader Questions:
Tackle This Modifier 25 and EKG Scenario
Question: We-ve received letters from CMS regarding modifier 25. We use this modifier on the [...]
