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
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tci ED Coding & Reimbursement Alert - 2009 Issue 12
READER QUESTIONS: Opt for E/M on Clamp Clot Clearup
Question: A 33-year-old non-pregnant woman presented to the ED with periumbilical pain after two days of heavy bleeding. The bleeding had decreased in the past two days, but the abdominal pain had increased to a 7 on a 10 scale. On examination, the physician discovers a large "clot" in the vaginal canal, which she removes with a clamp. Lab results report that the clot was "largely fibrinated blood and debris." The physician diagnosed vaginal bleeding. Is there a procedure code for the removal of the polyp (I was thinking 58558), or would I consider the clot removal when...
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