Billing and Coding in the ED

Question 1

Each patient’s visit to the ED requires three main documentation elements:

Answer 1

1. history
2. physical examination
3. making medical decision

Question 2

ICD:

Answer 2

international class of diseases

the more specific supports a higher level of service

Question 3

ED codes are called […].

Answer 3

Evaluation and Management codes (E&M)

Question 4

What are the three sets of codes?

Answer 4

1. diagnosis
2. procedure
3. complexity of service

Question 5

Distinguish the ICD-20 code:

I21.4

Answer 5

I = disease of the circulatory system
21 = acute myocardial infarction
4 = non-STEMI

Question 6

CPT:

Answer 6

Current Procedural Terminology (CPT) standardized codes for billing every type of service

Question 7

E&M codes represents the […]. There are […] levels measured with […] for new and established patients.

Answer 7

level of service complexity for the patient visit; 5; different designations

Question 8

E&M Code for levels 1-5.

Answer 8

1. 99281
2. 99282
3. 99283
4. 99284
5. 99285
   CC. 99291/99292

Question 9

CCT 99291 vs 99292

Answer 9

99291 = 30-74 minutes

99292 = each additional 30 minute increment

Question 10

CCT is the time spent…

Answer 10

1. interviewing the pt
2. talking to the family
3. looking at old records
4. talking to specialists
5. interpreting results etc.

Question 11

If a physician spends less than 30 minutes providing CCT then…

Answer 11

add a note stating that time so pt may be billed as a level 4 or 5