Three significant changes that will affect reimbursement rates go into effect January 1, 2026:
Conversion factor changes
Relative Value Unit (RVU) efficiency adjustment
Practice Expense changes
If you're a Find-A-Code subscriber, there's no need to worry. Find-A-Code's fee calculators are ready for the change. You can count on Find-A-Code for the most complete and accurate information you need as a medical coder/biller.
tci ED Coding & Reimbursement Alert - 2008 Issue 7
Reader Questions: Use Modifier on 'Involuntary' Services
Question: A patient presents to the ED with a police escort. An officer tells the front desk that the patient is there for a court-ordered drug test for cocaine. How should I code this encounter?
Texas SubscriberAnswer: When the patient is ordered to submit to a procedure or service, attach modifier 32 (Mandated services) to the CPT code. This lets the payer know that the service is "related to mandated consultation and/or related services (e.g., third-party payer, governmental, legislative or regulatory requirement)," according to the CPT 2008 manual.
On the claim, report the following:
- 80100 (Drug...
To read the full article, sign in and subscribe to tci ED Coding & Reimbursement Alert.
You have ED coding questions, and we deliver money-in-the-bank answers to help you defeat your claim issues and secure optimal reimbursement.
Stay in the know and avoid federal reproach with your subscription to TCI’s ED Coding and Reimbursement Alert.
Current newsletters added each month
Fully searchable archives - over 2100 articles
ALL years/issues back to 1998 organized by year and issue
Codes mentioned in articles are linked to Code Information pages
Code Information pages link back to related articles
This feature is currently unavailable for online purchase. For more information, please call 801-770-4203 or Contact Us.
Quick, Current, Complete - www.findacode.com