tci ED Coding & Reimbursement Alert - 2019 Issue 2

Reader Question: Know the Rules When Communication Problems Exist

Question: A patient who is unable to communicate clearly and to explain her medical problems presented to the ED. Her condition prevented the physician from obtaining a complete history of present illness (HPI) and ROS from her. Therefore, the doctor could not develop a definitive assessment. He called the patient’s previous physician to discuss her medical problems. Including face-to-face patient time (45 minutes) and telephone calls (45 minutes) to other providers, the doctor spent a total of 90 minutes on this patient on the same day. How should I charge for this scenario? Which E/M codes and modifiers...

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