tci ED Coding & Reimbursement Alert - 2001 Issue 7

Use Building-Block System To Determine E/M Levels for ED Treatment of Asthma

Acute asthma results in about 1.5 million ED visits each year. ED physicians typically bill an E/M service for these cases. The real coding challenge comes from determining the medical decision-making for the E/M, 99281-99285 (ED visit for the evaluation and management of a patient), and deciding when to choose 99285 versus 99291 (critical care, evaluation and management of the critically ill or critically injured patient; first 30-74 minutes).  Caral Edelberg, CPC, CCS-P, president and CEO of Medical Management Resources Inc. in Jacksonville, Fla., strongly advocates and uses a system that will guide coders through what...

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