tci ED Coding & Reimbursement Alert - 2010 Issue 11

Reader Questions: Tread with caution if considering DOA billing

Question:  A patient arrives at the ED dead on arrival; the emergency medical technician (EMT) informs the physician that the patient "appeared to be having a heart attack when we arrived, and expired during CPR [cardiopulmonary resuscitation]. The ED physician tries CPR again for three minutes, but documented no history, physical exam, or medical decision making; the nurse's notes only said "DOA, physician pronounces px dead." Can I bill 99281 and 92950 for this encounter? West Virginia SubscriberAnswer: You cannot report 99281 (Emergency department visit for the evaluation and management of a patient, which requires these 3 key...

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