tci ED Coding & Reimbursement Alert - 2000 Issue 2

Beware Proposed Screening Fees From Third-party Payers

Should your emergency department (ED) or emergency physician group accept set screening fees and/or unique screening codes from third-party payers for low-level, non-emergent services? Or are you better off insisting on coding each service individually and risking denials based on lack of a specified emergency medical condition?Background Federal lawspecifically the 1986 Emergency Medical Treatment and Active Labor Act (EMTALA)requires EDs to provide all patients who present in the department requesting care with a medical screening examination (MSE) that is sufficient to rule out the presence of an emergency medical condition. With the increase in managed care in the...

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