tci ED Coding & Reimbursement Alert - 2015 Issue 6

Reader Questions: Include Diabetes Diagnosis Only If Condition Affects Current Treatment

Question: A patient with a plan of care in place for her type II diabetes reports to the ED complaining of a painful left index finger. She says the digit has been red and swollen for the past three days, and she rates the pain a 6 on a 10-point scale. The non-physician practitioner (NPP) provides a level-three E/M service, during which he notes “fluctuance limited to area surrounding lateral nail fold. Final Dx: Paronychia” Using a scalpel, the NPP performs incision and drainage (I&D), flushes the area with saline and dresses the wound. Does this qualify...

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