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AHA Coding Clinic® for HCPCS - 2004 Issue 4

Update on coding of facility emergency department and clinic levels of service

Since the implementation of OPPS, hospitals have coded clinic and emergency department (ED) visits using the same CPT code as physicians. CMS has recognized that existing Evaluation and Management (E/M) codes correspond to different levels of physician effort but do not adequately describe non-physician resources. Although hospitals were anticipating that CMS would propose a national, uniform E/M coding system in 2003, the agency chose not to do so. As a result, in 2003 the AHA and the American Health Information Management Association convened an independent panel of experts to develop a set of coding guidelines for CMS. In the...

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