tci ED Coding & Reimbursement Alert - 1999 Issue 6

Set Up Internal Log to Track Payer-Specific Coding Policies

Many ED physician groups staff the emergency departments at different hospitals, and see patients covered by many different health plans. In addition, emergency medicine billing and coding companies may submit claims for groups in different cities and different states.Billing requirements and policies often differ from payer to payer. Some pay for conscious sedation, some consider it bundled into the procedure. Some recognize modifiers, some dont, or only recognize a few. Even Medicare carriers have different policies in different regions, our sources report.In North Carolina, in the ED or any new patient visit, Medicare doesnt want to see...

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