tci ED Coding & Reimbursement Alert - 2003 Issue 8

Are You Billing for Burns Correctly? Not if Youre Overlooking the 16000 Series

You may mistakenly believe you should report an E/M code (99281-99285) only for emergency department (ED) burn visits, but you are losing out on valuable reimbursement by forgetting about the 16000 series. Suppose a patient comes into the ED with a first-degree burn from a kitchen fire. Code 99282 has a relative value unit (RVU) of 0.73, while code 16000 has an RVU of 2.02, more than twice the value paid for the E/M. The appropriate code from the burn series could raise your reimbursement substantially. You will usually see cases that warrant reporting both the E/M...

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