tci ED Coding & Reimbursement Alert - 2009 Issue 12

READER QUESTIONS: Code Pair Provides Pinpoint Pressure Ulcer Dx

Question: A 75-year-old reports to the ED for inspection of sores on her back. The nonphysician practitioner (NPP) performs an expanded problem focused history and an expanded problem focused exam, and then diagnoses a stage I pressure ulcer on her lower back. The NPP refers the patient to a dermatologist for treatment of the ulcer. How should I report this diagnosis? Indiana Subscriber Answer: You should submit a pair of codes; one to represent the stage of the pressure ulcer, and another for the ulcer itself. On the claim, report the following: • 99282 (Emergency department visit for the...

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