ED Coding and Reimbursement Alert

Question: A 27-year-old pregnant patient reports to the ED after an accident: she fell down the stairs at her workplace, and is complaining of right wrist pain. The ED physician provides a level-three E/M, during which she diagnoses and wraps a sprained right wrist ligament; then, she performs obstetrical ultrasound (US). After examining the US, the physician determines that the fetus has not sustained any injury. The notes show the physician felt the injury did not have any effect on the fetus. How should I code this encounter? Do I need a modifier? Florida Subscriber Answer: Youll need two modifiers: one to separate the E/M and the US, and another to specify the physicians role in the US treatment. You should also go back and check the notes to see how far along the woman was, as this will affect US code choice. On the claim, report the following: " [...]