Tag: Emergency Department Coding

ICD code updates

ICD-10-CM Code Updates: New, Revised & Deleted Codes You Need to Know

For the 2026 ICD-10-CM code updates, you’ll find 16 new “R” codes that offer greater detail for reporting pain and tenderness in the pelvic, perineal, subpubic, abdominal, and flank regions. The existing code R10.2- (Pelvic and perineal pain) will become a parent code. A notable addition is R11.16 (Cannabis hyperemesis syndrome (CHS)), specifically for nausea […]
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Emergency Department Coding: Best Practices and Challenges

Emergency Department Coding: Best Practices and Challenges

Table of Contents The Emergency Department Coding Process Unique Challenges of Emergency Department Coding CPT Documentation Updates and Emergency Department Coding ED Facility Coding and National Standards The Limitations of Final Diagnosis-Based Payment ED Utilization and Evolving Treatment Paradigms The Importance of Emergency Department (ED) Coding in Medical Coding Companies Conclusion Emergency Department coding is […]
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CMS Rules for Coding Emergency Department Claims | Best Practices

CMS Rules for Coding Emergency Department Claims | Best Practices

The Centers for Medicare and Medicaid Services (CMS) has consistently authorized hospitals to establish and utilize their own coding guidelines for emergency department facility claims. CMS makes clear that “[a]s long as the services furnished are documented and medically necessary and the facility is following its own system, which reasonably relates the intensity of hospital […]
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How to Approach Emergency Department Claim Denials

How to Approach Emergency Department Claim Denials

By now, many hospitals have received denials for emergency department level-of-care coding. We could legitimately ask, “how did this happen?” Today we shall address how it started, why it’s important, and potential institutional responses. Denials for emergency care are not new. The spectrum of denials and the audacity with which payers deny claims now strains […]
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