tci ED Coding & Reimbursement Alert - 2006 Issue 8

Special Report: Find Out if Your E/M Levels Can Withstand Heightened Scrutiny

Payers will give high-level E/Ms a closer look, experts say There is some potentially bad news for ED coders: Based on evidence from a just-released poll, claims reporting level-four and level-five evaluation and management services could be examined even further under the payer's microscope.Why? A recent survey by American Hospital Directory showed that E/M levels in the ED increased in the past few years. For example, 24 percent of ED E/M visits were level four (99284, Emergency department visit for the evaluation and management of a patient, which requires these three key components: a detailed history; a detailed...

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