tci ED Coding & Reimbursement Alert - 2018 Issue 5

You Be the Coder: Which E/M Code Applies When ED Patient Becomes Inpatient?

Question: We saw a patient in the ED for a possible broken bone following a car accident. The ED physician diagnosed a fracture and a collapsed lung, and immediately arranged for the patient to be admitted to the hospital by a pulmonologist for treatment. Once the patient was admitted and in his inpatient bed, the ED physician examined an additional injury, which was a laceration sustained in the accident, and on the same day as the ED evaluation, repaired it. We reported an ED code and the claim was denied. I was always told to bill the E/M code...

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