Three significant changes that will affect reimbursement rates go into effect January 1, 2026:
Conversion factor changes
Relative Value Unit (RVU) efficiency adjustment
Practice Expense changes
If you're a Find-A-Code subscriber, there's no need to worry. Find-A-Code's fee calculators are ready for the change. You can count on Find-A-Code for the most complete and accurate information you need as a medical coder/biller.
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...
To read the full article, sign in and subscribe to tci ED Coding & Reimbursement Alert.
You have ED coding questions, and we deliver money-in-the-bank answers to help you defeat your claim issues and secure optimal reimbursement.
Stay in the know and avoid federal reproach with your subscription to TCI’s ED Coding and Reimbursement Alert.
Current newsletters added each month
Fully searchable archives - over 2100 articles
ALL years/issues back to 1998 organized by year and issue
Codes mentioned in articles are linked to Code Information pages
Code Information pages link back to related articles
This feature is currently unavailable for online purchase. For more information, please call 801-770-4203 or Contact Us.
Quick, Current, Complete - www.findacode.com