Recent content by Mojo

  1. M

    coding from x-ray report in ED

    Yes, since the provider who was responsible for direct care of the patient diagnosed the fracture, the radiology report can be used for more specificity. http://www.hcpro.com/HIM-323519-5707/QA-Emergency-room-documentation-and-radiology-reports.html
  2. M

    Help with Dx code

    I would code it as a toxic effect plus any manifestations of the poisoning.
  3. M

    ER injections

    In lieu of a specific facility guideline, we end all ED facility services when the provider writes the order for inpatient or observation services. Most of my recent facilities want all injections and infusions billed until the patient leaves the ED. Your facility should have a policy regarding...
  4. M

    concurrent infusion coding

    A concurrent infusion is a new drug/substance infused at the same time as another drug/substance. It is not time based and does not need to be infused at the exact same time as the other therapeutic infusion. Your second infusion would be a concurrent infusion if the same site was used for both...
  5. M

    Medical coding outsourcing overseas

    Yeah right, Raja. Many of us prefer to keep our jobs and our protected health information in the US. SymMetric Revenue Solutions formerly known as Apollo Information Systems, Inc. in Fort Myers, FL terminated 38 coders two months ago because they chose to outsource to India. My feedback...
  6. M

    Axilla abscess/Sebaceous cyst removal??

    I agree with 10061.
  7. M

    Critical Care ?

    ACEP has info on billing ED facility critical care: http://www.acep.org/Content.aspx?id=30428 I look for the criticality of the patient (unstable VS, organ impairment/failure), an intervention and at least 30 minutes of care rendered by the nursing/ancillary staff (after subtracting any billed...
  8. M

    FAST charge on ER bill

    From the ACEP website: FAQ 1. What is the appropriate code for the FAST (Focused Assessment with Sonography in Trauma)exam? There is no specific CPT-defined code for the usual clinical FAST exam. Rather, the exam is reportable as two distinct limited ultrasound examinations, when the...
  9. M

    Ultrasound Guidance in ED

    Look at 93970/93971 for the DVT and to examine the inferior vena cava - 93979.
  10. M

    ARNP Triage in the ED

    E/M services provided in the ED use 99281-99285. Both the hospitalist and the EDP can use these codes on the same date. Outpatient E/M services on the same DOS that result in a hospital admission are included in the Hospital Care codes. For a non-Medicare consult in the ED, use the...
  11. M

    CPT for placement of femoral quinton dialysis catheter

    36555 for patients younger than 5 years 36556 for age 5 and older
  12. M

    help with procedure-Can I please get

    This would not be coded as a central venous access procedure since the documentation does not support the catheter tip terminating in the subclavian or innominate vein. Usually, the internal jugular, subclavian and femoral veins are used for central line access in the ED. Look at the...
  13. M

    Bivalving Short Arm Cast

    I agree with 29700. Gauntlet (covering the hand and fingers like a glove) describes the short arm cast.
  14. M

    Intrabursal Injections??

    Are you looking for the actual administration CPT (20600, 20605, 20610) or a medication?
  15. M

    # of Diagnosis or Treatment Options in the ER

    We cap it at 3 points. If we did not limit it to one problem, a kiddo with a febrile seizure discharged with a antibiotic for AOM would be a level 5. I noticed that Novitas and E/M University allow a maximum of 1 new problem to the examiner in their MDM calculator/worksheet.
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