Medicare Compliance & Reimbursement

Coders often under-report their epistaxis claims. If you can't differentiate a complex anterior nosebleed repair from a simple one, you're costing your ED nearly $20 per misidentified claim. Further, coders who cannot discern a reportable nosebleed repair encounter from an E/M will subject the practice to upcoding concerns. Check out these basics for each type of nosebleed repair to nail your coding each time. Consider E/M For Non-Active Nosebleeds If a patient reports to the ED with a nosebleed, and the physician stops the bleeding with basic methods, the coder usually chooses an E/M code,confirms LindaMartien, CPC, CPC-H, coding specialist at National Healing Inc. in Boca Raton, Fla. These methods can include minimal attempts at stoppage, including ice or brief, direct pressure. The key to these encounters is that the physician did "not perform a billable procedure, so the E/M is the only way to capture the services the physician [...]