http://www.supercoder.com/forum/ Supercoder Forum Forum: Ed Coding - Recent Topics en Tue, 07 Sep 2010 06:25:16 +0000 http://www.supercoder.com/forum/topic/procedure-documentation-in-er#post-1623 Tue, 07 Sep 2010 00:40:51 +0000 Barbara Jackson 1623@http://www.supercoder.com/forum/ <p>If the ER MD orders a splint and it is documented on the tsheet that the nurse applied but the nursing notes don't have any documentation that it was done...Can you code from this? Thanks... </p> http://www.supercoder.com/forum/topic/heart-and-neoplasms#post-1589 Thu, 02 Sep 2010 09:17:51 +0000 amy farquharson 1589@http://www.supercoder.com/forum/ <p>Ecode for elderly with oblect in larynx- laryngoscopy performed wth microscope? </p> http://www.supercoder.com/forum/topic/dental-caries-and-acute-toothache#post-1501 Wed, 25 Aug 2010 11:26:38 +0000 Renee Spiriti 1501@http://www.supercoder.com/forum/ <p>patient comes to the ED with toothache. After evaluation the impression is acute pain and dental caries. Patient is discharged with Lortab. Would you code acute pain as PDX and dental caries as secondary? </p> http://www.supercoder.com/forum/topic/digital-block-for-foreign-body-removal#post-1489 Wed, 25 Aug 2010 03:44:04 +0000 Barbara Jackson 1489@http://www.supercoder.com/forum/ <p>If a patient comes in with foreign body in his finger and they inject lidocaine to remove foreign body without an incision can you charge 64450? or is injection included in the E/M? Does anyone know where I can find infomation on this topic? Thanks in advance! </p> http://www.supercoder.com/forum/topic/cerumen-removed-by-ed-physician#post-1386 Wed, 11 Aug 2010 02:27:29 +0000 Renee Spiriti 1386@http://www.supercoder.com/forum/ <p>Documentation states that the ED physician personally removed a small portion of impacted cerumen with a curet. However, the remainder could not be removed because it was too hard. The guideline states he should document how much time and the resources used to remove the cerumen. Should we code '69210' with mod -52 or not code it at all? </p> http://www.supercoder.com/forum/topic/hydration-infusion-and-intial-codes#post-57 Thu, 15 Oct 2009 17:17:08 +0000 TONYA SHARP 57@http://www.supercoder.com/forum/ <p>CAN I CHARGE 96360 WITH 96365? I WAS TOLD I CAN NOT CHARGE 96360 WITH 96365 BECAUSE THEY BOTH WAS AN INTIAL CODE SO IF TH IV STARTS AS A HYDRATION AND A HOUR LATER A PUSH IS ORDERED I WAS TOLD TO NOT CHARGE 96360 TO CHARGE IT AS 96365 AND NOT TO CHARGE 96374 TO CHARGE THE PUSH AS 96375 BECAUSE THEY BOTH ARE INITIALS. AND I DON'T UNDERSTAND THE CONCURRENT 96368 WHAT IS THE DIFFERENCE WITH 96368 AND THE SEQUENTIAL 96367?? HELP PLEASE.. </p> http://www.supercoder.com/forum/topic/defibrillator-discharge#post-957 Mon, 07 Jun 2010 17:00:57 +0000 Karn Pederson 957@http://www.supercoder.com/forum/ <p>Patient presented due to his defibrillator going off, but having no symptoms. Patient discharged with diagnosis of defibrillation by ICD. Would you code observation for suspected cardiovascular condition or is there a more appropriate code? </p> http://www.supercoder.com/forum/topic/cpt-4-code-id-vs-excision#post-697 Sat, 17 Apr 2010 17:46:23 +0000 Marcia Odal 697@http://www.supercoder.com/forum/ <p>Does the following procedure fall under I&amp;D codes or excision codes? Or neither? Thanks in advance for any assistance. Marcia</p> <p> ED Procedures (Blister left ring finger superficial anesthesia with Cetacaine, clenased with Betadine, opened with #11 blade, C&amp;S of fluid taken, blister unroofed, further cleanse and bandage with Neosporin. Well tolerated.). </p> http://www.supercoder.com/forum/topic/cpt-code-92567-tympanometry-in-the-ed#post-672 Wed, 14 Apr 2010 15:09:43 +0000 Pamela Nealy 672@http://www.supercoder.com/forum/ <p>I have ED physician who hass approached me about utilizing tympanometry in the ED. Upon further discussion and collective review of COPT coding options, the physician stated that the clinical indications for performing the Tympanometry is to determine the compliance or flexibility of the eardrum. This would be done in children and adults presenting with "head colds" , URIs, dizzy or deaf. This assists in the differential diagnosis of Serous and Otitis medias. The tympanometry can be performed by a nurse or doctor and the measurement documented as are vital signs. According to the physician this is not screening as in hearing or audiologcal (92551) as originally though, but rather 92567 Tympanometry (impedance testing). </p> <p>1. If done in the ED , would this be an additional service in addition to the ED E&amp;M as technical component if done by Nurse? or professional if done by Dr? or at all - is it part of the "evaluation" I see no excludes or includes not as to its use with the ED E&amp;Ms.</p> <p>2. Is documenting the resulting pressure ( of both ears) as well as the physicians ED diagnosis sufficient for recording results and interpretation?</p> <p>4. This code appears to have APC reimbursement - not sure of fee schedule implications for other payers.</p> <p>Thanks for any help or guidance! </p> http://www.supercoder.com/forum/topic/time-based-coding#post-674 Wed, 14 Apr 2010 18:00:09 +0000 Theresa Somes 674@http://www.supercoder.com/forum/ <p>For a time-based counseling such as 'smoking cessation' 99406 counseling greater than 3 minutes up to 10 min. In order to charge for this service, doesn't the amount of time '&gt;3 minutes' have to appear in the documentation? </p> http://www.supercoder.com/forum/topic/icd-9-code-for-zoned-out#post-18 Tue, 22 Sep 2009 09:05:13 +0000 supercoder.newbee 18@http://www.supercoder.com/forum/ <p>A 55-year-old patient reports to the ED, saying that for the past three weeks, he has “zoned out” for no reason several times, but did not lose consciousness during any of the episodes. The physician provides a level three E/M, diagnoses “episodic abnormality of consciousness; etiology uncertain,” and refers the patient to a neurologist. Which ICD-9 codes apply to this condition? </p> http://www.supercoder.com/forum/topic/billing-for-ed-services-that-cross-days#post-553 Thu, 25 Mar 2010 06:17:13 +0000 Linda Abbott 553@http://www.supercoder.com/forum/ <p>The patient enters the ER. Mar.3, at 11:30 p.m., March 4th, at 12:30 a.m. the patient receives therapeutic infusion. We put a 25 modifier on the EM level with the date the pateint entered the ER, March 03, we put March 04 for the date for the infusion code, this was the date documented by nursing. Nowe we are getting an edit stating that we have an EM level with a 25 modifier but do not have an S or T procedure. According to CMS transmittal 1151, ER services with a 450 revenue code are to have the date the patient entered the ER. does this mean even though nursing documented they did the infusion March 4, when we enter the charge we can enter a service date of March 03, thereby, resolving the edit. Thanks Linda </p> http://www.supercoder.com/forum/topic/student-question-icd-9-code-for-prescriptions-given-in-er#post-379 Mon, 22 Feb 2010 17:27:20 +0000 Pamela Hillebrandt 379@http://www.supercoder.com/forum/ <p>I have an assignment to which I must answer that the primary procedure done in ER was only medications prescribed. What type of code do I use? Thanks </p> http://www.supercoder.com/forum/topic/periodontal-disease#post-149 Fri, 11 Dec 2009 20:22:42 +0000 Nyla Deputy 149@http://www.supercoder.com/forum/ <p>Patient shows up with mouth pain in the ER. Diagnosis is periodontal disease with possible abcess. Instead of going to a dentist, he comes in the ER. Treatment: He was only given antibiotic and tylenol and sent home. What would this be coded under for ICD9 and CPT? I am new to coding. Please help. </p> http://www.supercoder.com/forum/topic/new-e-codes-effective-10109#post-49 Wed, 07 Oct 2009 14:42:56 +0000 KATHLEEN RHODES 49@http://www.supercoder.com/forum/ <p>Is anyone having difficulty knowing when and to what codes to assign the new External Cause <code>E0000.0-000.8</code> and Activity codes <code>E001-030</code>?</p> <p>Kate in Upstate NY </p>