ED Facility Level ?

lsolway

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What ED Facility Level are you using for a patient who:

* drives up to ED, stays in car
* nurse does triage
* then nurse does a Covid swab
* Dr comes out to talk to patient for a few minutes
* patient leaves

Thanks in advance
 

such78

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What ED Facility Level are you using for a patient who:

* drives up to ED, stays in car
* nurse does triage
* then nurse does a Covid swab
* Dr comes out to talk to patient for a few minutes
* patient leaves

Thanks in advance
Is there an ER report in file?
 

lsolway

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Suchang78-
Yes, there is an ER report. I see many of these daily, all with reports. I can also speak from my own experience. My report has the HPI and ROS completed; I'm assuming from the nurses/triage notes. Dr basically just said to self quarantine and would call with the results.
Our Level 3 describes: "Preparation for lab tests described in CPT 80048-87999. (We exclude clean catch urine, using Level 2).
Nasal swab by ER nurse vs ex: Phleb blood draw.
 

such78

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Suchang78-
Yes, there is an ER report. I see many of these daily, all with reports. I can also speak from my own experience. My report has the HPI and ROS completed; I'm assuming from the nurses/triage notes. Dr basically just said to self quarantine and would call with the results.
Our Level 3 describes: "Preparation for lab tests described in CPT 80048-87999. (We exclude clean catch urine, using Level 2).
Nasal swab by ER nurse vs ex: Phleb blood draw.
Usually, when I code ER, If the swab test is positive, it is level 3.
If it is negative, assign the EM level is based on what chief complained.
I assign the EM level is from what final diagnosis/impression from ER report, not from nurse/triage notes. When I use nurse/triage notes when I need to confirm what ER doctor/NP/PA has done on patient. Ex., patient has finger fracture/dislocation, and ER doctor does not mention splint application in report, I check the nurse/triage notes to make sure it is done that I wont miss coding it.
 
Last edited:

SharonCollachi

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Usually, when I code ER, If the swab test is positive, it is level 3.
If it is negative, assign the EM level is based on what chief complained.
I assign the EM level is from what final diagnosis/impression from ER report, not from nurse/triage notes. When I use nurse/triage notes when I need to confirm what ER doctor/NP/PA has done on patient. Ex., patient has finger fracture/dislocation, and ER doctor does not mention splint application in report, I check the nurse/triage notes to make sure it is done that I wont miss coding it.
Okay, I'll bite. What about a positive swab makes it automatically a level 3?
 

such78

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Usually, when I code ER, If the swab test is positive, it is level 3.
If it is negative, assign the EM level is based on what chief complained.

Okay, I'll bite. What about a positive swab makes it automatically a level 3?
check your facility's coding policies. When patient is tested positive without other diagnoses, we assign level 3.
 
Last edited:

lsolway

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Thanks Suchang, I appreciate your feedback.

We use the Facility Level Coding Guidelines from ACEP. Level III states: Preparation for lab tests described in CPT 80048-87999 codes.
(A clean catch urine is a Level II, even though the CPT code is in the above grouping).
These Covid swabs are not collected by a phlebotomist, but is collected by the nurse in the parking lot. Level III seemed high for this to me, whether negative or positive.
 
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