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tci ED Coding & Reimbursement Alert - 2018 Issue 4

E/M Coding: Here's How to Determine When 99285 is Warranted

Tackle this confusing question by checking these documentation items. Does your doctor fear reporting high-level ED code 99285 and only reserve it for the rarest of cases? Or does he bill the code with reckless abandon any time a patient is very sick, even if the documentation is scant? Hopefully, the answer for most emergency departments lies somewhere in the middle, but it's clear that EDs could use a refresher on how to bill this high-level code. Background: In a recent issue, Emergency Department Coding Alert reported that Part B payer Palmetto GBA conducted a review of 99285 claims...

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