tci E/M Coding Alert - 2018 Issue 2

Reader Question: Base ED E/M Code on Problem and Work, Not Final Dx

Question: A patient presents to the ED with chest pain. The patient receives a complex cardiac workup to identify and treat or rule out a life-threatening cardiac event. By the end of the encounter, the final diagnosis was indigestion. Would this service be severe enough to warrant a 99285? North Dakota Subscriber Answer: Yes. There is a certain complexity associated with emergency department (ED) coding. Sometimes coders who have limited ED coding experience may find it difficult to understand the complexity of identifying the appropriate treatment or diagnosis in the ED, according to Todd Thomas, CPC, CCS-P, president for...

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