tci ED Coding & Reimbursement Alert - 2005 Issue 2

Reader Questions: More Physicians Doesn't Mean Higher E/M

Question: The ED doctor sees a child for a fracture. He performs x-rays and administers IV morphine for pain control, then discusses the patient with an orthopedist. Then, a second ED physician performs conscious sedation - which he documents separately - while waiting for the  orthopedist to reduce the fracture. All documentation meets the criteria for level four. Should we bump this to a level five at this point or leave it at level four?Tennessee Subscriber Answer: According to CPT, in this situation, the first emergency department physician should bill for the appropriate evaluation and management service (99281-99285)...

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