tci ED Coding & Reimbursement Alert - 2003 Issue 5

Beyond the Basics: Zero In on the Acuity Caveat: Documentation Details

Even the most experienced coders are no exception to the rule: Everyone can benefit from continuing E/M education. Read this in-depth analysis on the level-five acuity caveat for advice you may have never heard before. If you're still unclear on when the acuity caveat applies, here's a quick rundown. The acuity caveat allows you, under certain circumstances, to report the ED level-five E/M code (99285) when you don't have complete documentation for the three components normally needed to justify that level: comprehensive history and examination, and medical-decision making of high complexity. When either the patient's mental and physical status...

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