Wiki ER Coding

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I have a question in regards to the MDM portion of E/M coding for ER visits specifically. We had a patient who was in to their Family Doctor the day before and was diagnosed with Strep Throat. She then came into the ER and was seen by an ER Physician for worsening symptoms. My training and experience has taught me that since this patient was never seen for the strep throat by any of our ER physicians we could count it has a New Problem. However the facility I am now working in is stating that they don't consider it this way. They just look and if the problem was established by any other physician, including one outside of our health system, then gets the points for an established problem.

I feel like this provider should get credit for a new problem because he had nothing to do with the patients visit the day before, although he does have access to those medical records. My current department states that they do not use the additional wording of (to examiner), they took this out and only consider if this is a new problem to the patient. I feel that the provider is not getting the credit he deserves this way, but maybe this is the norm for Emergency room E/M coding?

Thoughts. New or Established problem.
Ed Response

This is not the typical way to bill ED Services. As per the Guidelines in the CPT book "No distinction is made between new and established patients in the emergency department". The Evaluation and Management Guidelines state "New Problem to examiner". I would request the reasoning behind this directive within your management and ask for written clarification as it could be considered under coding which can affect your companies bottom line.