tci ED Coding & Reimbursement Alert - 1999 Issue 1

Correctly Apply 99285 Acuity Caveat to Optimize E/M Coding

  Latest on Accurate Usage of CPT Code 99285 from SuperCoder's E/D Coder:     Salvage Your 99285 Claims With This Can't-Miss Caveat   A patient reports to the ED with a severe illness or injury. Encounter notes indicate that the physician provided a comprehensive exam and high-level medical decision making (MDM) ... but the history documentation is limited. What do you do? The level five ED acuity caveat, a very specific coding exception, could help you code this service as a 99285 " provided the encounter notes reflect a level-five exam and MDM. Before using the ED caveat, however...

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