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 - 2007 Issue 7
READER QUESTIONS: Think Twice Before Coding Death Pronouncement
Question: When the hospital asks an ED physician to pronounce a patient's death, what code should we report for the service? We were thinking 99231. Alabama Subscriber
Answer: Most insurers will not pay for this service, so you would usually not code for death pronouncement. Typically ED physicians pronounce a patient's death as a courtesy to the attending physician. If you are absolutely determined to try to garner payment for the service, you might consider 99231 (Subsequent hospital care, per day, for the evaluation and management of a patient, which requires at least two of these three key components:...
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