tci ED Coding & Reimbursement Alert - 2022 Issue Q2

Reader Questions: Never Base E/M Code Choice on Condition

Question: Our ED sees a lot of patients with multiple comorbidities, and many of these patients have presented with COVID-19. Can we bill for a higher-level E/M service to reflect these more complicated encounters? New York Subscriber Answer: As with any ED evaluation and management (E/M) service, you’ll establish the level of service based on the history, exam, and medical decision making (MDM). The trick is to not get distracted by outside knowledge of complications and comorbidities. Stick to what’s documented. That’s not to say comorbidities won’t ever move a COVID-19 E/M encounter from one...

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