tci E/M Coding Alert - 2018 Issue 4

Specialty Spotlight: Emergency Department: Understand When 99285 Is Too Much or Not Enough

Level of care should be determined by elements and rise with time. "According to an Office of Inspector General (OIG) report, billing of lower level emergency department codes is declining while billing of higher level codes is increasing. The OIG determined that from 2001 to 2010, 'Physicians' billing of the highest-level code (99285) rose 21 percent, increasing from 27 to 48 percent.'" So, said Part B Medicare Administrative Contractor (MAC) Palmetto GBA in its Comparative Billing Report (CBR) released Nov. 6, 2017. Has your emergency department (ED) been guilty of adding to these inflated claims? Want to find...

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