Medicare Compliance & Reimbursement - 2010 Issue 12
ED E/M Coding: 99281-99285: Use NOPP Info to Accurately - Choose MDM Level -- and E/M Code
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Article Overview
This article discusses emergency department evaluation and management coding with a focus on nature of presenting problem (NOPP) as a contributing factor in selecting the appropriate service level. It is aimed at coders and auditors who work with ED E/M documentation and want a clearer understanding of how presenting-problem severity, comorbidities, history, examination, and medical decision making fit together. The article covers broad NOPP categories, the relationship between NOPP and ED E/M leveling, and examples of documentation considerations.
Why This Topic Matters
Accurate ED E/M reporting depends on evaluating the presenting problem in context with the rest of the encounter documentation. Understanding the article helps coding professionals assess relevance for training, compliance review, and level selection workflows.
Article Sections
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Get to Know 5 Levels of NOPP
Introduces the general NOPP framework and summarizes the broad severity categories discussed in the article.
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Consider Comorbidities Before Choosing NOPP Level
Discusses how broader patient factors and existing conditions can affect the overall assessment of presenting-problem severity.
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High NOPP Does Not Always Mean 99285
Explains the relationship between NOPP assessment and ED E/M code selection, including the need to review the full documentation set.
What You Will Learn
- How the article frames nature of presenting problem within ED E/M coding
- Which broad NOPP severity categories are discussed
- Why comorbidities are relevant to ED encounter assessment
- How presenting-problem assessment fits with history, examination, and medical decision making
- What types of documentation considerations are highlighted for emergency department visits
Who Should Read This
- Medical coders
- Coding auditors
- Compliance staff
- Revenue cycle professionals
- Emergency department documentation reviewers
Codes Discussed
Code Ranges Discussed
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