tci ED Coding & Reimbursement Alert - 2019 Issue Q3

Reader Question: Evaluate Dislocation Options

Question: A patient reported to the ED complaining of severe elbow pain. After a detailed  history and examination the physician diagnosed an elbow dislocation. The physician used manipu­lation to reduce the joint, prescribed painkillers, and instructed the patient to follow up with his primary care physician (PCP) in two weeks. What is the best CPT® code for the reduction? Supercoder Subscriber Answer: The AMA’s stance is that the intent of the “with anesthesia” codes is to reflect a formal process performed in the operating room As a result, you would typically use the “without...

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