tci ED Coding & Reimbursement Alert - 2002 Issue 10

Guarantee ED Specialists Their Pay With the Acuity Caveat

Coding for patients with life-threatening illnesses and injuries can require less stringent evaluation and management documentation. But the documentation waiver contained in 99285 can raise havoc for E/M coders unless they know how to handle the paradox of documenting the undocumentable.Complete Data Not Always Available For a severely ill patient, extenuating circumstances may prevent emergency physicians and staff from collecting the complete data required to submit 99285. The level-five acuity caveat provides a way both to deliver timely treatment and to recover appropriate reimbursement, even if some of the information required by documentation guidelines is missing from the...

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