Tag: Emergency Department Coding

Electrocardiogram (EKG) Coding Guidelines

Guidelines for Interpreting Electrocardiogram (EKG) Coding

The guidelines for interpreting EKGs could vary according to the specific treatment situation. Patients presenting at the emergency department (ED) to undergo an electrocardiogram (EKG or ECG) can present a coding challenge. The main issue revolves around how to accurately report the physician’s services for the patient. Is it appropriate to utilize the EKG CPT® […]
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Rules for Coding Emergency Department

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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Emergency Department Coding

Differentiating Between Professional and Facility Emergency Department Coding

ED professional codes are typically assigned by professional coders with specialized training in emergency medicine coding. The CPT® code set, including ED code descriptors and applicable rules, guide this choice based on the documented history, physical exam, and medical decision-making, as indicated by the chief complaint and the nature of the presenting problem. In addition, […]
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Emergency 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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