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tci ED Coding & Reimbursement Alert - 2004 Issue 12

Reader Question: Make Pronouncement Free of Charge

Question: How should I code for a patient who presented to the ED with cardiac arrest and died? The physician didn't spend enough time for a critical care code, and he just documented the time of death and discussion with the primary-care physician to sign the death certificate. Our physicians think the severity of the situation overrides the lack of documentation.Rhode Island Subscriber Answer:  If the chart documentation would support a level-five evaluation and management service "within the constraints imposed by the urgency of the patient's clinical condition and/or mental status," you could invoke the acuity...

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