tci ED Coding & Reimbursement Alert - 2004 Issue 5

Reader Question: Report ED E/M for Help With Delivery

Question: How should I report a scenario in which the emergency department physician helps an obstetrician/gynecologist in the vaginal delivery of an infant in the emergency department? What kinds of documentation should I include to strengthen this claim?West Virginia Subscriber Answer: First, you must document medical necessity for the assistance at delivery. However, rather than reporting the delivery code and appending modifier -82 (Assistant surgeon [when qualified resident surgeon not available]), your cleanest coding option may be to report one of the ED E/M codes:99281 - ED visit for the E/M of a patient, which requires these three...

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