Medicare Compliance & Reimbursement - 2002 Issue 10
Coders Have One Profession, Two Sets of Guidelines
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Article Overview
This article discusses the long-standing contrast between physician coding and hospital coding in the emergency department. It is aimed at coders, coding managers, and revenue cycle professionals who work with ED documentation and need to understand how coding guidance is interpreted in different settings. The piece focuses on broad guidance themes from federal rules and ICD-9-CM-era coding practices, along with how ED documentation is viewed in relation to presenting complaints and final diagnoses.
Why This Topic Matters
Emergency department encounters often involve incomplete information at the time of service, so coding approach affects how the record reflects the visit. Understanding the differing perspectives can help coding professionals evaluate relevance when reviewing ED documentation and guidance.
Article Sections
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Signs and Symptoms in ED Coding
Introduces the dispute over how presenting complaints are handled in emergency department coding and contrasts physician and hospital coding perspectives.
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Sharks Versus Jets?
Summarizes the two viewpoints on whether coding should emphasize the presenting problem or the final diagnosis, with reference to federal guidance and ICD-9-CM practice.
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ED Reality Trumps All
Describes how emergency department work is documented and why the encounter may involve multiple services before a final diagnosis is established.
What You Will Learn
- How emergency department physician coding and hospital coding differ in emphasis
- How federal guidance and ICD-9-CM specificity concepts are discussed in relation to ED encounters
- Why ED documentation may reflect both the presenting complaint and the final diagnosis
- How coders are encouraged to think about the overall encounter from a documentation perspective
Who Should Read This
- Medical coders
- Emergency department coders
- Coding managers
- Hospital coding staff
- Physician practice billing staff
- Revenue cycle professionals
Codes Discussed
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