tci ED Coding & Reimbursement Alert - 2014 Issue 2

Reader Question: Extent of Treatment and Depth Of Burn Will Justify A Separate E/M Code

Question: When my ED physicians treat a burn, can we also report an ED E/M service on the same claim? New Mexico Subscriber Answer: Lesser burns will likely only require an E/M service, but you can typically report both if the documentation shows evidence of separately identifiable burn treatment. If a burn does not require any treatment, then a code from the 16000 series may not be appropriate and you should typically report the service with an E/M code. For example a college student reports to the ED concerned about his painful sunburned back. The attending doctor examines the...

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