ED Coding and Reimbursement Alert

If swine flu hysteria hits the area, will your ED be ready? Swine flu's earlier-than-expected sweep into some states has coders everywhere wondering how -- and what -- they should code when the ED is involved in administering a vaccine to combat the condition. The kicker: It isn't that there is no way to code for the H1N1 administration; there are new CPT and new Medicare G codes specifically tailored for reporting the service, confirms Michael Granovsky, MD, CPC, FACEP, president of Medical Reimbursement Systems Inc. (MRSI), an ED billing company in Woburn, Mass. These codes, however, represent facility resources in the ED setting. Of course, that won't stop ED patient presentations for swine flu vaccination. Follow this FAQ for the best advice on ethically coding H1N1 administration. What Can the ED Physician Report on the Claim? If you code in the ED setting, administration "is a facility service, so [it is] [...]