ED Coding and Reimbursement Alert

Question: When the hospital asks an ED physician to pronounce a patient's death, what code should we report for the service? We were thinking 99231.


Alabama Subscriber

Answer: Most insurers will not pay for this service, so you would usually not code for death pronouncement. Typically ED physicians pronounce a patient's death as a courtesy to the attending physician.

If you are absolutely determined to try to garner payment for the service, you might consider 99231 (Subsequent hospital care, per day, for the evaluation and management of a patient, which requires at least two of these three key components: a problem-focused interval history; a problem-focused examination; and medical decision-making that is straightforward or of low complexity).

However, you should check with the insurer before reporting any codes for death pronouncement.

Explanation: If the patient is dead before the ED physician arrives, and the ED physician is just there to confirm that fact, then the patient is no longer covered by insurance (health benefits end at the time of death).

Since insurance will not cover the pronouncement, you-d have to bill the patient's estate and try to recoup payment that way. Most ED groups provide this as a courtesy service and for public-relations reasons may decide not to submit a bill.