Don't have a TCI SuperCoder account yet? Become a Member >>

Emergency Department Coding & Reimbursement Alert

You Be the Coder:

Know How to Demonstrate Medical Necessity

Question: In your previous issue, there was an article about how the OIG downcoded a claim in which the ED made the decision to admit a patient to the hospital ("This ED Error Is Among CMS's Examples of How Not to Report Claims"). In the article, you noted that the OIG determined there was no medically necessary reason for that admission. [...]