tci ED Coding & Reimbursement Alert - 2004 Issue 5

Reader Question: Use Modifier -24 for Unrelated E/M

Question: A patient reported to the emergency department three weeks ago for pain in his right shoulder. The physician treated him for a fractured clavicle. Yesterday, the same patient came into the ED with a fever and nausea. The physician treated both symptoms and sent him home. Can we report this visit, or is it part of the fracture-care global package?Arizona Subscriber Answer: Since the fever and nausea were not related to the clavicle fracture, you can report them separately. Code the ED E/M service from the 99281-99285 series based on the chart documentation. Depending on your payer's...

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