tci Medicare Compliance & Reimbursement - 2013 Issue 22

Reader Question: Can A V Code Be A Primary Diagnosis?

Question: Our ED recently treated two patients that sustained injuries when their car veered off the highway. There was also a third passenger in the vehicle that was not clearly hurt, but she wanted to be fully evaluated due to the severity of the accident. The physician performed a level 2 evaluation and management service before releasing the non-injured patient. How can we prove medical necessity for the E/M service? Answer: You may use a V code as a primary diagnosis since the patient is asymptomatic. On your claim report: 99282 (Emergency department visit for the evaluation and management...

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