tci ED Coding & Reimbursement Alert - 2017 Issue 5

Getting It Right Can Help Your Practice Revenue

Consider the difference in payment for a level 5 ED E/M code 99285 (Emergency department visit for the evaluation and management of a patient…) 2017 WRVU: 3.80 and a 2017 payment of $175.85 with that of critical care 99291 (2017 WRVU: 4.50 and a 2017 payment of $226.46). If you failed to accurately report a legitimate critical care service because of inadequate time documentation or failure to recognize a patent as critically ill or injured that is about $50 lost revenue. The 2015 Medicare national frequency distribution of ED services looks like this: If...

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