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Re: Coding-ER visitFrom: ainsron (ainsron@sbcglobal.net)Thu Jan 17 09:00:30 2008
99281 Emergency department visit for the evaluation and management of a patient, which requires these three key components: A problem focused history; A problem focused examination; and Straightforward medical decision making. Counseling and/or coordination of care with other providers or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are self limited or minor. 99282 Emergency department visit for the evaluation and management of a patient, which requires these three key components: An expanded problem focused history; An expanded problem focused examination; and Medical decision making of low complexity. Counseling and/or coordination of care with other providers or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of low to moderate severity. 99283 Emergency department visit for the evaluation and management of a patient, which requires these three key components: An expanded problem focused history; An expanded problem focused examination; and Medical decision making of moderate complexity. Counseling and/or coordination of care with other providers or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of moderate severity. 99284 Emergency department visit for the evaluation and management of a patient, which requires these three key components: A detailed history; A detailed examination; and Medical decision making of moderate complexity. Counseling and/or coordination of care with other providers or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of high severity, and require urgent evaluation by the physician but do not pose an immediate significant threat to life or physiologic function. 99285 Emergency department visit for the evaluation and management of a patient, which requires these three key components within the constraints imposed by the urgency of the patient's clinical condition and/or mental status: A comprehensive history; A comprehensive examination; and Medical decision making of high complexity. Counseling and/or coordination of care with other providers or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of high severity and pose an immediate significant threat to life or physiologic function. These are your choices, depending on intensity of service. However, one additional thing you need to consider, she is within the global period for your surgery, unless you can code a diagnosis unrelated to your surgery, you will not be paid. Even if you code for a different diagnosis, you still probably won't be paid and will go through several appeals before you see a penny for this visit. Welcome to the wonderful world of Medicare. Ronald E. Ainsworth, MD, FACOG -----Original Message----- From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of Glen Elrod Sent: Wednesday, January 16, 2008 8:34 PM To: Multiple recipients of list OB-GYN-L Subject: Coding-ER visit A 75 yr old lady, postop day number 4 from a TAH/BSO and nodes for endometrial cancer presents to the ER with complaint of right hip pain. I happen to be close to the ER and I go ahead and see her rather than the ER doc. I would venture to say that I did an expanded problem focused HPI and exam and had straight forward medical decision making. Is the E/M code for seeing someone in the ER that of observation or is there another that I've missed? Or is this visit somehow tied up in the global package? Thanks, Glen _____ Looking for last minute shopping deals? Find <http://us.rd.yahoo.com/evtQ734/*http:/tools.search.yahoo.com/newsearch/ca tegory.php?category=shopping> them fast with Yahoo! Search.
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