tci ED Coding & Reimbursement Alert - 2009 Issue 12

READER QUESTIONS: Check Off Components Before Coding Drug-Seeking E/M

Question: Occasionally, we get patients in the ED that the physician decides are engaging in drug-seeking behavior some time after the initial E/M service. When this occurs, can we report an E/M code? If so, how would we choose ICD-9 codes for the encounter? Oregon Subscriber Answer: If the documentation indicates that the physician provided all three components of an E/M service (history, exam, medical decision making), then you could report a low-level E/M code such as 99282 (Emergency department visit for the evaluation and management of a patient, which requires these 3 key components: an expanded problem focused...

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