tci ED Coding & Reimbursement Alert - 2004 Issue 9

READER QUESTIONS: Old Problems Are New in the ED

Question: Should we consider all patients who come through the emergency department to be "new"? What if the patient comes in every few months for headaches - would he be an established patient? What if he comes in every few months for headaches, but doesn't see the same provider - would he be new?Arkansas Subscriber Answer: All patients who present to the emergency department (ED) are new - even if they periodically present with the same condition. According to CPT, instructions for the 99281-99285 series state, "The following codes are used to report evaluation and management services provided...

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