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E&M code for DOA in ER

  1. #1
    Default E&M code for DOA in ER
    Exam Training Packages
    Could anyone help me..... I work in ER Physicians billing and I recvd a chart yesterday where the pt was DOA. The pt expired in the ambulance on the way to the hospital. On the chart the Dr. did a review of the systems. He also did a check up on the eyes, heart, and lungs. An ekg was performed and a pulse ox was taken.

    Would this qualify as a 99285 since the pt expired?

    Thanks for the help,

  2. Default
    I would go for "99499" as this scenario does not satisfy the key face-to-face requirement.
    Thanks,
    Jagadish, CCS-P, CPC

  3. #3
    Default


    Jagadish,

    Thanks so much for the reply.

    Dawn

  4. #4
    Default
    Just out of curiousity, did your MD do a death summary, In Pa I don't know if this is in other states, when the pt is doa or dies, our docs can get pd for a death summary which is billed as a d/c summary.

    Check with your local carrier.


    Just my thoughts,

    Roxanne Thames, CPC









    Quote Originally Posted by dawndi67 View Post
    Could anyone help me..... I work in ER Physicians billing and I recvd a chart yesterday where the pt was DOA. The pt expired in the ambulance on the way to the hospital. On the chart the Dr. did a review of the systems. He also did a check up on the eyes, heart, and lungs. An ekg was performed and a pulse ox was taken.

    Would this qualify as a 99285 since the pt expired?

    Thanks for the help,

  5. Default
    I would agree with rthames052006, if the doctor performed a death summary, you should be able to code a discharge. My doctor's would list time taken and sometime I am able to go higher than 99238, so watch and see if he documents time, if time is not documenated, use 99238. Like rthames052006 stated check with your carrier.

  6. #6
    Default
    I will have to check the "death summary" info out...... wow you learn something new everyday......

    Thank you for all your help.

    Dawn

  7. #7
    Default bill discharge code, but only when face-to-face
    Hi - I just read today in the MultiSpecialty Coding Pro that one can bill a 99238 or 99239 for a death pronouncement. The physician who bills has to be with the patient and also the discharge must be billed on the date of service, even if the paperwork is delayed to another day.

    Hope that helps.

    Carol

  8. Default
    99238 can be billed for a dead patient if he was admitted to hospital inpatient with proper admitting physician documentation. In this case, the patient is still outpatient....not admitted to hospital floors. I feel 99238-239 is not applicable for this scenario.
    Thanks,
    Jagadish, CCS-P, CPC

  9. Default
    Please read the CMS transmittal on this issue:

    http://www.cms.hhs.gov/Transmittals/...ds/R1460CP.pdf
    Thanks,
    Jagadish, CCS-P, CPC

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