mwagone1
Contributor
As a Pennsylvania Auto insurer, we reimburse per Medicare guidelines (at a 110% of Medicare Fees).
I was wondering if anyone could offer some insight in regards to coding head injuries without brief LOC. We use the Medicare Scoresheet and know that it is only a guide, that we do have to make some clinical inference when it comes to something not specifically mentioned on the scoresheet. There is some debate as to whether a closed head injury, mild concussion, or even a documented “bump” to the head (which we see a lot in MVA injuries) would allow for Moderate MDM. I feel that it does, especially since signs and symptoms of concussion could present well after the initial ED visit, however I am finding it difficult to find information supporting my belief. Any guidance or opinions would be appreciated, or if anyone could direct me to where I might be able to find additional information (one way or the other) I would appreciate it!
Thanks in advance!
I was wondering if anyone could offer some insight in regards to coding head injuries without brief LOC. We use the Medicare Scoresheet and know that it is only a guide, that we do have to make some clinical inference when it comes to something not specifically mentioned on the scoresheet. There is some debate as to whether a closed head injury, mild concussion, or even a documented “bump” to the head (which we see a lot in MVA injuries) would allow for Moderate MDM. I feel that it does, especially since signs and symptoms of concussion could present well after the initial ED visit, however I am finding it difficult to find information supporting my belief. Any guidance or opinions would be appreciated, or if anyone could direct me to where I might be able to find additional information (one way or the other) I would appreciate it!
Thanks in advance!