Coding Challenge / E/M

ED Coding Question: Observation or Other E/M Code?

Question: A 42-year-old patient reports to the ED early on Tuesday morning for evaluation of uncontrollable shaking in her extremities and severe pain in her neck. The EP admits the patient to observation at 7 a.m. and orders blood tests and a CT scan — however, the shaking continues to worsen. The EP consults with a [...] Related articles:

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November 16, 2009
Coding Challenge / E/M / modifier 25

Ophthalmology Coding: GDX, VF, & Temp Plugs — How Many Modifiers?

Question: A patient came in for a GDX and visual field (VF) tests. During the same visit, the ophthalmologist put in temporary plugs. Can we get paid for all services on the same day? I know the office visit needs a modifier. Do I need to put one on the GDX & VF, too? Answer: Provided the [...] Related articles:

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  2. CIGNA Opens Black Box: Get Paid With Modifiers 25 & 59 You now have clear-cut policies to apply, including 1...
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October 31, 2009
Coding Challenge / E/M

Does My E/M Coding Have to Match Hospital’s E/M Coding?

Question: My physician removed a catheter in an outpatient hospital exam room. Should I include this removal as part of the E/M? If E/M is appropriate, will the hospital also report an E/M? And, if so, do the physician and hospital E/M codes need to match? Answer: You should include simple Foley catheter removal as part [...] Related articles:

  1. Must Hospital Admit Codes and Admission Show Same DOS? Overlook this rule, and risk leaving rightful E/M dollars on...
  2. Answers To Your Hospital Admission, Subsequent Care Coding Questions Revenue Booster: Here’s when you can claim a consult...
  3. Capture ‘Patient Limbo’ Period With These Observation Coding Steps Internist deciding on admission? That’s your signal to look...

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October 28, 2009
Coding Challenge / E/M

E/M Coding Education: Does ‘No SOB’ Fall Under HPI or ROS?

Question: For a chart with a chief complaint of resolving pneumonia, a note indicates, “No coughing, SOB.” Should I give the pediatrician credit for this ‘no coughing & no shortness of breath’ statement under history of present illness (HPI) or as a review of systems (ROS)? Answer: This is a gray area of E/M coding that [...] Related articles:

  1. E/M Coding Focus: Geriatric Patients & DementiaDetermine HPI or ROS during assessment for geriatric patients. Your...
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  3. Test Your E/M Coding & Billing Savvy Are you an E/M Emeritus? Take this quiz to...

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October 12, 2009
E/M / Hot Coding Topics

Watch Out for 3 Telephone Service Coding Pitfalls

Caution: You may need to incorporate the call into an in-office E/M service. If you’re reporting services your physician provides over the phone, but you’re not getting paid, the reason might be one of two things — you’re not following the coding rules surrounding the codes or your payer just isn’t paying for those services. Check out these [...] Related articles:

  1. Test Your E/M Coding & Billing Savvy Are you an E/M Emeritus? Take this quiz to...
  2. 5 Rules Pinpoint Date of Service for Laboratory ClaimsTip 3: Here’s DOS advice for archived samples. You can’t...
  3. This 4-Step Coding Process Grabs $125 Extra in Vasectomy-Related PaymentTurn to V25.x for your diagnosis code choice. Vasectomies are...

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October 10, 2009