E/M Coding Alert - 2000 Issue 11
Reader Question: ED Nurses
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Article Overview
This reader Q&A discusses how outpatient facility procedures are captured for billing purposes and why a physician charge master may not always align with facility charge capture. It is aimed at coders, charge master staff, and facility billing teams working with emergency department services and APC-based outpatient payment issues. The article covers general guidance on selecting facility-relevant charges, identifying services that may not be separately payable, and distinguishing physician-only from facility-reportable items.
Why This Topic Matters
Accurate facility charge capture affects outpatient billing completeness and helps avoid listing services that are not separately payable or not appropriate for facility claims. The topic is especially relevant to emergency department operations where nursing-performed procedures and related services may be handled differently from physician billing.
What You Will Learn
- How outpatient facility procedures are generally captured for billing purposes
- Why a physician charge master may not fully match facility charge capture needs
- How emergency department services can relate to facility billing and APC considerations
- What types of services may not be separately payable at the facility level
Who Should Read This
- Hospital outpatient coders
- Facility charge master staff
- Emergency department billing personnel
- Revenue cycle professionals
- Compliance staff
Codes Discussed
Code Ranges Discussed
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