tci ED Coding & Reimbursement Alert - 2000 Issue 10
Reader Question: Fractured Coccyx
Question: If someone comes in with a fractured coccyx, should we enter the specific procedure code and the evaluation and management (E/M) code, or will the ICD-9 code and the E/M code suffice?Roslyn WeinsteinBeth Israel Medical Center, New YorkAnswer: The CPT codes for outpatient encounters communicate the services provided to the patient, and the ICD-9 codes communicate the reason (i.e., medical necessity) the services were performed. Under the ambulatory payment classifications (APCs), all provided services should be captured and reported with the appropriate CPT code for hospitals to receive full reimbursement. At the same time, to be...
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