ED Coding and Reimbursement Alert

Question: A patient reports to the ED with complaints of fever, decreased urine output, and a skin rash. Suspecting sepsis, the ED physician orders a twoview chest x-ray, inserts a Foley catheter (due to nurse difficulty with the procedure), and orders blood collection for testing. After reviewing the labs and x-ray results, the physician detects impaired oxygen availability in the patient's blood; final diagnosis is "SIRS, no organ dysfunction." What condition does this note describe, and what services can I report separately from the E/M service? Oregon Subscriber Answer: The patient has a form of sepsis, which you'll report with a 995.9x code. On the claim, report the following: • 71020 (Radiologic examination, chest, 2 views, frontal and lateral) for the x-ray • modifier 26 (Professional component) appended to 71020 to show that you are coding only for the physician's services • 51702 (Insertion of temporary indwelling bladder catheter; simple [...]