tci ED Coding & Reimbursement Alert - 2010 Issue 9

Reader Questions: Check Catheter Use for Thoracentesis Type Clues

Question: A 50-year-old male patient is brought to the ED via ambulance; the emergency medical technician (EMT) tells the physician that the patient was mostly complaining of right-sided chest pain during the ride to the hospital; the physician provides a levelfive E/M service while stabilizing the patient; during the E/M, the physician discovers that the patient has been experiencing shortness of breath for a month, a moderate cough for the past three weeks, and occasional night sweats. A two-view chest X-ray reveals a moderate right pleural effusion. The physician performs thoracentesis, which reveals gross purulent material; the physician uses...

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