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tci ED Coding & Reimbursement Alert - 2008 Issue 1

READER QUESTIONS: Fifth Digit Can Be Vital for Claim Acceptance

Question: A patient with extrinsic asthma reports to the ED in the throes of a severe asthma attack. While providing critical care services to the patient, the physician diagnoses the patient with status asthmaticus. Total critical care time is 37 minutes. On the claim, I reported 99291 with 493.00 as a diagnosis and received a denial. What did I do wrong?Kentucky Subscriber Answer: Your diagnosis coding was slightly off, which likely led to the denial. On your claim, you submitted 493.00 (Extrinsic asthma; unspecified) as the ICD-9 code, but you should have chosen 493.01 (-...

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