ED Coding and Reimbursement Alert

Here's why lining up presenting problem levels with 99281-99285 could spell trouble. Failure to identify the nature of the presenting problem (NOPP) level for each patient can cost you, as this ED E/M element is essential to protecting your 99281-99285 claims. Get smart with this NOPP FAQ, which will help lead you to the correct level each time. What is NOPP? NOPP is the "disease, condition, illness, injury, symptom, sign, finding, complaint, or other reason for the visit to the ED -- with or without a diagnosis being established at the time of the encounter," explained Caral Edelberg, CPC, CCS-P, CHC, president of Edelberg Compliance Associates in Baton Rouge, La., during a recent Coding Institute audioconference (www.audioeducator.com). In a nutshell: Ask yourself, "What risk is there if the physician provided no treatment?" The answer to that question is your NOPP. What Coding Component Does NOPP Factor Into? You'll use NOPP information [...]