tci ED Coding & Reimbursement Alert - 2007 Issue 8

Reader Question ~ Wait for Test Results Before Settling on Dx

Question: A patient reports to the ED complaining of wheezing and breathlessness. The physician conducts a level-three E/M service. Suspecting emphysema, the physician conducts a spirometry with graphic record and a myleography. How should I report this encounter?Missouri Subscriber Answer: The answer depends on whether the physician confirms an emphysema diagnosis. The CPT codes will be the same regardless of the final diagnosis, but the ICD-9 codes will differ.Case 1 -- Confirmed diagnosis: The physician confirms a diagnosis of emphysematous bleb. On the claim, you would report the following:- 99283 (Emergency department visit for the evaluation and...

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