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Emergency Department Coding & Reimbursement Alert

Procedure Coding:
Inject These New Influenza Codes Into Your Charge Master for 2014
Patient age and means of administration will drive your immunization  code choice. ... Read more
ICD-10 Coding:
Don't Have A Seizure Over Choosing Dx for Mental Disorder Presentations In The ED
Watch for specificity in documentation to select the most granular code listed for substan... Read more
Services for Prisoners:
Avoid Getting Robbed On Payment for ED Services to Patients in Custody
Know your rights when submitting claims to Medicare patients brought in by law enforceme... Read more
Reader Question:
Make Sure You Are In The Same facility Before Using a 27 Modifier
Question: Should modifier 27 be appended on the visit to a second hospital when a patien... Read more
Reader Question:
Are ICD-9- PCS Codes Required For ED Facility Coding?
Question: Should we be capturing ICD-9 procedure codes for ED facility coding?  I u... Read more
You Be the Coder:
Get Specific With Final Aneurysm Presentation Dx
Question: What diagnosis codes would you assign for the following patient encounter? H... Read more
CPT® 2014 Update:
Read Between The Lines To Find New Language In The 2014 CPT® Book
Get the Inside Scoop On New Codes And Subtle Changes In The Preamble Language To Several... Read more
CPT® 2014:
Review Three Key Updates in the CPT® Manual Introduction
1. Who can deliver services: In the introduction section, a new line appears in the firs... Read more
Procedure Coding:
Make the Right Choice for Foreign Body Removal Procedures
Location and means of extraction will usually determine the code selection A common pr... Read more
Common ICD-9 Codes for Foreign Body Removals
930 (Foreign body on external eye) 930.1 (Corneal foreign body) 931 (Foreign body in... Read more
ICD-10 Coding:
Check For Site and Sequencing When Coding For Neoplasms, Diseases of Blood and Blood Forming Organs
Read on for ED Relevant ICD-10 Tips To Prepare For The Big Transition Need to jumpstar... Read more
Reader Question:
Map Out How To Report A Global Service Component From a Second Physician
Question: One of our ED physicians removed nasal packs (patient had them put in at the s... Read more
Reader Question:
The Unexpected Return Of A Referred Patient Can Cause Global Problems
Question: We have concerns about how to report a follow up visit to a patient that was s... Read more
You Be the Coder:
Can A V Code Be A Primary Diagnosis?
Question: Our ED recently treated two patients that sustained injuries when their car ve... Read more
Hyperbaric Oxygen Therapy:
Dive Deep For the Details on Hyperbaric Oxygen Therapy
Be sure to report by session for accurate payment of your HBO services. Are you fully ... Read more
ICD-10 Coding:
Highlight These ED Diagnoses From ICD-10-CM's Chapter 1
Read on for inside info on coding for SARS, sepsis and HIV diagnoses This issue of ED ... Read more
Coding Strategies:
Revisit Your Laceration Repair Coding Policy for Wound Checks And Adhesives
Medicare rules for simple repairs can differ from those for intermediate and complex cod... Read more
Reader Question:
Medicare to Accept Revised 1500 Form Starting January 2014
Question: How will the CMS 1500 form change to allow ICD-10 reporting? Vermont Subsc... Read more
Reader Question:
How Solid is the 72 Hour Rule for Fracture Care Reporting? Find Out
Question: I was wondering if I could have your feedback regarding a topic of conversatio... Read more
Reader Question:
What Constitutes Teaching In A Critical Care Scenario?
Question: Some of my docs are stuck on the “teaching” exclusion of the criti... Read more
Reader Question:
Not So FAST On Assigning Ultrasound Codes For Blunt Trauma
Question: What would be the CPT®code for ultrasounds done in ER for blunt chest and ... Read more
Reader Question:
Which One is Chief? Is More than One Chief Complaint Allowed?
Question: A patient comes into the ED suffering a panic attack, with complaints of chest... Read more
You Be the Coder:
Is This Enough Documentation For A Separately Reportable E/M Service?
Question: My group wants to report an E/M code along with this chart for a laceration re... Read more
CPR:
Resurrect Your CPR Coding With These Tips
These tips on documentation and what can be separately reported can save your life in au... Read more
Burn Coding:
Stay Out Of The Fire With These Burn Coding Tips
Check chart documentation to determine the best codes to describe your burn care Burn ... Read more
Burn Payment:
Know Your Burns Codes Pay Rates
Choosing the right code has significant payment implications Check out this chart to s... Read more
Coding Tips:
Is it A Splint Or Is it Strapping? Check The Documentation Before Choosing
The materials used will help to narrow down your selection. When a patient reports to ... Read more
Reader Question:
What In The World Is The Global Period On An E/M Code?
Question: One of our providers saw a patient in the ER who had a wound on her knee. All ... Read more
Reader Question:
With The CCI, You Must Modify
Question: When CPT® code 99284 is billed with CPT® code 11643 for the same date ... Read more
Reader Question:
Consider All the Facts Before Close Your Repair Coding
Question: Our emergency physician sutured a bleeding post-operative seroma at the incisi... Read more
You Be the Coder:
There is No Margin For Error When Measuring Lesion Excision Sites
Question: When the ED physician removes a benign lesion, how should I measure the excisi... Read more
Audit Strategies:
Are These 2 HPI Glitches Putting You At Risk For E/M Audit Scrutiny?
How the “Acuity Caveat” could be sabotaging your documentation. As an ED c... Read more
Proposed Medicare Fee Schedule 2014:
Breaking News: EDs Could See A 3 Percent Increase in Medicare Payments
The CMS proposed Rule Gives a Preview of What To Expect in 2014 More cash from CMS could ... Read more
How do you decide which category describes the repair in question?
A simple repair is usually single layer, with no particulates, no contamination. You&... Read more
Reader Question:
At First Those Earrings Looked Like An Accident, But Eventually They Grow On You
Question: Can I please get other opinions on the correct ICD-9 code for an infected embe... Read more
Reader Question:
All Observation Codes Require At Least A Detailed History
Question: We just received a denial for a moderate level observation care service (99235... Read more
Reader Question:
Apply Reduced Services Modifier For Unsuccessful Procedures
Question: A patient came into the ED with a medial dislocation of his elbow. The physici... Read more
Reader Question:
Choose Only One Code for Multiple Observations
Question: I have an operative report in front of me that indicates two of our group&rsqu... Read more
You Be the Coder:
Can You Report an E/M When Procedures Are The Primary Reason For a Visit?
Question: We had this chart recently that mostly seems to be about sewing up the lacerat... Read more
Regulations:
Will Your Compliance Plan Make the Grade? Find Out What The ACA Requires
CMS is dragging its heels in creating guidelines. Here’s  expert advice on wh... Read more
Coding for Transports:
Steer Clear Of Trouble When Reporting Transport Services
You can separately report transport services if the code conditions are met. Patients ... Read more
Coding Strategies:
Listen Carefully to These 4 Tips For Recouping Cerumen Removal Pay
Why you’ll get denied if you report 69210 more than once per episode. Patients o... Read more
Keep Track of These Face-to-Face Services RVU Stats
Face-to-face services pay much better than supervision by radio. Check out the RVUs and ... Read more
Check What the ACA Says About Compliance Programs
Review the following directive from the Affordable Care Act creating the requirement for... Read more
Reader Question:
Avoid Complaints From The Chief Over Your HPI Documentation
Question: Can I get others’ opinions on chief complaint and number of elements in ... Read more
Reader Question:
Bill Critical Care Under One TIN
Question: Our ED physician saw a patient in the morning for a critical care service. Lat... Read more
Reader Question:
The Past Is History, So Let's Examine The Present
Question: How should we count allergy status in determining E/M levels? The ED physician... Read more
Reader Question:
Do Some Diagnostic Testing Of Your EKG Documentation
Question: When billing for an EKG interpretation, am I correct in thinking that there mu... Read more
You Be the Coder:
Don't Be Blind To Reporting An E/M Code With An Eye FBR
Question: I would like to know what other ED coders would assign for this ER visit: ... Read more
PQRS Reporting:
Get The Scoop on The Value Based Payment Modifier and Group Reporting Option
The Penalty Phase begins in 2015, So Read On To Learn How to Avoid Those Cuts in your Me... Read more
Review These Group Practice Reporting Options
If you’re reporting your quality data using the group designation, get familiar wi... Read more
Procedure Coding:
Make Sure You Have Your Facts Straight Before Facing Pacemaker Interrogation
Investigate This Little Known Procedure To See If Should Be Added To Your Charge Master ... Read more
Eye FBR Procedures:
Don't Be Blind to 3 Factors When Coding Ocular Foreign Body Removals
Look Closely At The Documentation For These Clues to Determine The Right Code Assignment... Read more
Reader Question:
Scratch That Itch With The Right Code For The Work Provided
Question: I need help with this one: Presenting complaint: Patient states that he ... Read more
Reader Question:
Don't Just Pay Lip Service to Vermillion Border Repairs
Question: How would you code through and “through” “laceration” ... Read more
Reader Question:
Don't Code Resident Services Off The Cuff
Question: If no linking statement by the attending is present, which part of the residen... Read more
You Be the Coder:
Headache Or Aneurism? Check These Cranial Nerve Symptoms To Help Make the Diagnosis
Question: There are several symptoms listed but what’s the best diagnosis in this ... Read more
Pediatric Coding:
Documentation Strategies Help You Ace Your Peds ED Encounters
CPT® Contains Age Specific Codes For Common ED Services. Check Out These Documentati... Read more
Peds ED Documentation:
Handy Checklist Helps You Ace Peds E/M Encounters
To be sure you’re capturing all the pediatric-specific information you should for ... Read more
ICD-10 Coding:
Apply These Laterality, Episode of Care, Tips For Pediatric Presentations
It’s Not Just Your P’s and Q’s That Need Minding Under ICD-10, Keep An... Read more
Reader Question:
Adverse Reaction Pay Depends on Insurer
Question: The ED physician performs simple repair of a 4.6cm-laceration on a patient&rsq... Read more
Reader Question:
Lay to Rest Questions on Nail Bed Repair
Question: Can I get help with a procedure codefor this nail bed repair? Note reads... Read more
Reader Question:
Let Your Fingers Do The Walking Before Choosing Your Repair Code
Question: Would this be considered complex or just a simplerepair? Wound Repair of 3.... Read more
Reader Question:
Make An Informed Decision Before Changing Providers
Question: My ED is exploring the idea of having a tech do infiltration, prep, and cleani... Read more
Reader Question:
Active Wound Care Codes Aren't Typical In the ED Setting
Question: I have a question about evaluation management levels for active wound care man... Read more
You Be the Coder:
Probe Deeply To Remove Thoracentesis Uncertainty
Question: How do I code the following situation? A thoracentesis tray was brought to the... Read more
Critical Care Coding:
Are You Documenting Your Critical Care Time Accurately?
Check out these resources to see if your policies are in order. Every ED coder knows c... Read more
Critical Care Strategies:
Get Ready for Increased Audit Activity On Critical Care Time
Hot spot: Prepayment edits of evaluation and management (E/M) code 99291. Medicare aud... Read more
Critical Care Resources:
Keep These CMS and MAC Critical Care Documentation Guidelines Handy
Ensure you’re following the rules by reviewing these 11 citations and quotes from... Read more
Reimbursement Alternatives:
You Could Be Missing Out On Section 1011 Funds
Don’t overlook this chance to get some payment for otherwise uncollectable account... Read more
Non Physician Providers in the ED:
Verify Signatures and NPI Numbers For Your NPPs Before Submitting Claims
Review the checklist below to make sure you are on the right path with the right provide... Read more
Reader Question:
Don't Get Blocked On Your Stand-Alone Pain Control Procedures
Question: Can I get paid for providing digital blocks? Maine Subscriber Answer: Fo... Read more
You Be the Coder:
Secrets of Selecting the Sialolithiasis Service Code
Question: The patient is a 54 year old female who presents with right sided face pain. E... Read more
Critical Care:
Review These Critical Care Bundling Rules to Ensure Your Code Choices Get Rave Reviews
Strategies get you ready for auditors' critiques. Critical care coding is often the targ... Read more
Obstetric Diagnosis Coding:
Can You Deliver on Your Diagnosis Coding for Obstetric Related Presentations?
Check out the most common pregnancy related diagnoses for the ED setting and get familia... Read more
Nasal Hemorrhage Procedures:
Plug Up Lost Revenue Leaks for Non-Active Nosebleeds
Check the chart carefully to see if a separate procedure is warranted for nose bleed pre... Read more
Reader Question:
Separate Documentation Key to Correct Modifier 25
Question: I am having trouble with my modifier 25 coding, specifically with my documenta... Read more
Reader Question:
Don't Report Bandage Wrap as Strapping Unless Payer Allows It
Question: A patient reports with a swollen right ring finger that she injured while catc... Read more
Reader Question:
3-Plus Trigger Point Shots Alter Code Choice
Question: A patient suffers whiplash from crashing his car into a parked vehicle, and th... Read more
You Be the Coder:
Measuring Lesion Excision Sites
Question: When the ED physician removes a benign lesion, how should I measure the excisi... Read more
EMR Strategies:
Know When And Where To Use Attestations In Your ED Charts To Stay Out Of Trouble
Shortcuts can help -- but beware of these audit pitfalls. As an ED coder, you may... Read more
Facility Reimbursement Update:
6 Areas Where You Can Tighten Up for Added Revenue
Are you under-reporting these common ED services? Emergency medicine patient volumes,... Read more
Reader Question:
Don't Say Nope to the NOPP, Nature of the Presenting Problem Must be Considered
Question: I was recently dinged in an internal audit for coding too low for things like ... Read more
Reader Question:
Verify What Is Really Bundled Into Critical Care
Question: We got a denial from an insurance company for an EKG interpretation (93010) th... Read more
Reader Question:
Don't Be Cavalier About Invoking The Caveat
Question: How does CMS audit records when the acuity caveat is used to explain the ED ph... Read more
You Be the Coder:
Read the procedure note front to back to determine if the postierior packing code is justified
Question: The ED physician cauterized and performed packing for an anterior nosebleed. H... Read more
NCCI Update:
Add Modifiers 24 and 57 to Your NCCI List for 2013
If you missed CMS Transmittal 1136 released Nov. 1, 2012, you’re behind the curve ... Read more
Brush Up on Your NCCI Modifiers
You will recall from prior Emergency Department Coding & Reimbursement Alert updates... Read more
Coding for ECGs:
3 Easy Steps Simplify Your Electrocardiography Diagnosis Coding
Make sure you have the clinical information for assigning the most accurate diagnosis co... Read more
Cardioversion Tips:
Jump Start Your Cardioversion And Defibrillation Coding With These Tactics
Split these procedures apart to prevent denials. Deciphering clinical chart details to... Read more
RVUs and Medicare Payments for Cardioversion and Related Codes
92960 (Cardioversion, elective, electrical conversion of arrhythmia; external) has a wor... Read more
Reader Question:
Don't Take A Shot At A High Level Code For An Injection Only Visit
Question: We had a patient present to the ED for a tetanus shot. Another physician had a... Read more
Reader Question:
Multi Trauma Visits Require High Decision-Making
Question: Patients who present with multiple trauma from a fall or motor vehicle acciden... Read more
Reader Question:
Negotiate This Labor Scenario To Avoid An Audit Strike
Question: If a woman presents to the ED in active labor, but the baby is not delivered b... Read more
Reader Question:
Can the Attending Bill For A NP's Procedure? Give Credit Where Credit is Due.
Question: An NP employed by the hospital wants to do sutures repairs in the ED and belie... Read more
Reader Question:
Form A Line To Learn About The Femoral Line
Question: A 22-year-old motor-vehicle accident victim reports with multiple injuries and... Read more
You Be the Coder:
Paronychia I&D With E/M
Question: I have a question regarding whether to apply both the E/M code and the procedu... Read more