Medicare Compliance & Reimbursement - 2004 Issue 4
You Be The Coder: Home In on MDM for Abdominal Pain
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Article Overview
This article reviews a coding scenario in the emergency department and focuses on how history, examination, data, and risk are weighed when selecting an E/M level. It is relevant to coders and billing staff working with ED services, particularly when the encounter involves a new problem, diagnostic workup, medication administration, and discharge with a prescription. The discussion centers on the CPT emergency department E/M series and general MDM considerations.
Why This Topic Matters
Emergency department E/M selection often depends on the overall level of medical decision-making, so understanding how service elements are evaluated can affect code accuracy and compliance.
What You Will Learn
- How emergency department E/M coding is influenced by medical decision-making
- What types of encounter features contribute to the overall complexity assessment
- How a case involving workup, medication administration, and discharge planning fits into ED code selection
- Which emergency department E/M level is discussed in relation to moderate complexity
Who Should Read This
- Medical coders
- Billing staff
- Emergency department coding specialists
- Revenue cycle professionals
Codes Discussed
Code Ranges Discussed
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