Wiki Coding for Triage Nurse's

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vdelucci

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I work for DOD. They want us to code 99281-52 to account for Triage Nurse's
work load. Is this correct?
 
you cannot append a 52 to an E&M sevice. look at CR1776 from 2002. Also the nurses time is part of the facility charge for the ER and should be built into the facility assessment tool for the facility E&M.
 
eadun2000 said:
DoD has its own set of guidelines and rules that supersede all others. If DoD wants it like that, that is what you do. It is not coding in the "real" world.
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Not true. I conducted onsite coding seminars to several military bases teaching correct coding to military coders and physicians. They follow the same coding conventions as everyone else.
 
mitchellde said:
Not true. I conducted onsite coding seminars to several military bases teaching correct coding to military coders and physicians. They follow the same coding conventions as everyone else.
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I worked as a coder and auditor for multiple military bases for several years. DoD follows the DoD CODING GUIDELINES which supersede all other coding guidelines. However, is there is not a specific guideline stated in DoD, then you do follow the coding conventions of the outside. I can also guarantee you that if you taught them something that went against the DoD guidelines, your teachings were not followed. DoD is in a world of their own.
 
Their manual on coding was revised in 2009 and states
These guidelines are derived from the following source documents:
International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM);
Current Procedural Terminology (CPT), 4th Edition;
Centers for Medicare and Medicaid Services (CMS) Documentation Guidelines for Evaluation and Management (E&M) Services;
Healthcare Common Procedure Coding System (HCPCS);
The American Hospital Association (AHA) Coding Clinic;
The American Medical Association (AMA) CPT Assistant;
The Coding Clinic for HCPCS.
These are exactly the same sources for guidelines all other coders use.
 
vdelucci said:
I work for DOD. They want us to code 99281-52 to account for Triage Nurse's
work load. Is this correct?
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One thought here for you though. When you say to account for the "workload" then is this an internal accounting. Just something one of the hospital administrators at one of the bases mentioned to me is that they use workload as means of assignment of personnel. Therefore as long as this is not being reported on a claim and used only for internal purposes then I understand why they want to do that. This might be a good question for you to address.
 
mitchellde said:
Once again I am not going to get into a public debate with you. However I taught according to the DoD manual which was revised in March of 2009. In the past they did have their own guidelines however when a question is asked for present times the answer must be placed in present times not the past. They follow the same coding guidelines as everyone else and this is stated in the DoD policy. Again I am asking that you be more respectful in your replies I do not insult you so please.
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First of all, I did not insult you. Once again, I stated a fact. Guidelines are updated yearly at MINIMUM. Here is the most current guideline version 3.2 which is effective 1 Aug 2009 and effective for audit use 1 Oct 2009. You can read the whole document at http://www.tricare.mil/ocfo/bea/ubu/coding_guidelines.cfm. To reach the specific guideline, click Professional Services and Outpatient Coding Guidelines located under Guidelines for coding professional and specialty services.

"1.1. Purpose
In the simplest sense, coding is the numeric or alphanumeric representation of written descriptions. It allows standardized, efficient data gathering for a variety of purposes. This document provides MHS-specific guidance for coding ambulatory and professional service encounters. These guidelines are derived from the following source documents, but take precedence over them:
International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM);
Current Procedural Terminology (CPT), 4th Edition;
Centers for Medicare and Medicaid Services (CMS) Documentation Guidelines for Evaluation and Management (E&M) Services;
Healthcare Common Procedure Coding System (HCPCS);
The American Hospital Association (AHA) Coding Clinic;
The American Medical Association (AMA) CPT Assistant;
The Coding Clinic for HCPCS.

This document is not intended to be an all inclusive reference for MHS coding guidance. In absence of specific MHS coding guidance, refer to the appropriate industry standard coding conventions. For specific workload issues not covered in this document, refer to service specific workload guidance.

Coding serves a variety of purposes. While it can provide a detailed clinical picture of a patient population, it can also be useful in overseeing population health, anticipating demand, assessing quality outcomes and standards of care, managing business activities, and receiving reimbursements for services."

Please read the above. It states SPECIFICALLY, as did I, "These guidelines are derived from the following source documents, but take precedence over them:"

Additionally it states, again as did I, This document is not intended to be an all inclusive reference for MHS coding guidance. In absence of specific MHS coding guidance, refer to the appropriate industry standard coding conventions. For specific workload issues not covered in this document, refer to service specific workload guidance.

Once again, you are giving out INCORRECT information and once again, when you are called out on it, you take it as an insult. Please do not send me anymore private messages.
 
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