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tci ED Coding & Reimbursement Alert - 2017 Issue 4

Reader Question: Take A Breath Before Billing For Nebulizer Treatments in the ED

Question: Our ED physician performs nebulizer treatments. What documentation gets this service paid? Michigan Subscriber Answer: Because the "incident-to" rules do not apply in the ED setting, the physician would have to perform the service themselves to bill for it with a medical necessity requirement and consideration of the supply cost. Occasionally, a physician's expertise is required to perform what would normally be a nursing function. Examples of this include starting a peripheral IV and difficult Foley catheter insertions. Proper documentation for these treatments includes a description of the procedure and why the physician's expertise was required. Finding a...

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