tci ED Coding & Reimbursement Alert - 2009 Issue 2

Reader Questions: ED Claims Cannot Contain EBV Screens

Question: A patient reports to the ED complaining of a sore throat, frequent fevers, and sore muscles. During the E/M service, the physician suspects mononucleosis and orders a heterophile screening. The patient's final diagnosis is Epstein- Barr virus (EBV). The physician recommends the patient maintain a regimen of bed rest and acetaminophen. How should I code this scenario? Will I be able to report the screening test separately? Florida SubscriberAnswer: You-ll be able to submit a code for the E/M, but not for the screening. Physicians can report 86308 (Heterophile antibodies; screening) only when the test occurs in the...

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