Emergency Department Records

Emergency Department Medical Coding

Codebusters Coding Teams are an on-demand, always on, coding solution for hospital-based EDs and their physician partners.

Accurate claim submittals are fundamental to meeting compliance requirements and financial needs. Reduce AR/DNFB, reduce denials, and collect more money faster

  • Immediate access to hundreds of fully vetted physician-based coders
  • Zero start-up cost to build and train the Coding Team
  • Per record and hourly billing options
  • 100% accuracy guaranteed
  • Always on On-Demand Coding Team – 24 hour turnaround time
  • Continuous auditing and transparent reporting
  • Proprietary workforce management platform
  • Full department outsourcing or simply a backup

Hospital emergency departments encompass both professional and technical services.  Codebusters provides coding and auditing services for both the facility claim and physician claim in an Emergency Department (ED) encounter.  Hospitals bill for an ED visit using APCs paid under the Outpatient Prospective Payment System (OPPS), whereas physicians will bill the same visit under the Medicare Physician Fee Schedule (MPFS). Coding and auditing considerations and procedures differ for each ED facility and physician. Professional services coding for the ED has peculiarities that make it different from E/M coding in other settings.  ED coding and auditing of facility and professional documentation, coding, and billing can be performed onsite or offsite.

In our professional audits of ED coding and reporting, we have found over 20% of procedural CPT codes omitted or under-coded, costing hundreds of thousands, if not millions of dollars in lost revenue. For instance, many ED coders, often with little experience and training, do not know that when there is treatment of a 1st degree burn there is an additional CPT code to be added to the evaluation and management code. Also, when a physician removes impacted cerumen, there is a separate procedural code added to the E/M code which elicits more revenue.

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Focus Area

  • Coding:  CPT procedural codes, Modifiers, E/M levels, injection and infusion coding
  • Billing and Claims:  Correct reflection of services, Properly bundled
  • Chargemaster:  Description, Revenue codes, CPT and HCPCS charges
  • Documentation:  Complete documentation for the proper reimbursement of charges, including injection and infusion start and stop times
  • Proper billing for level of care (emergent, urgent, clinic)

Non-Physician Practitioner Billable Services

  • Nurse Practitioners (NPs)
  • Physician Assistants (PAs)
  • Clinical Nurse Specialists (CNSs)
  • Nurse Midwives (NMs)
  • Clinical Social Workers (CSWs)
  • Clinical Psychologists (CPs)
  • Certified Registered Nurse Anesthetists (CRNAs)
  • Occupational Therapists
  • Physical Therapists

ICD-10 Q&A

  • ICD-10-CM/PCS – Part 70: Question & Answer

    Author: Linda Kobayashi, BA, RHIT, CCS Editor: Andrea Wong, BS, RHIT For the past 2-3 weeks, we have addressed the cardiovascular system. Its impossible to cover everything and that has never been our intention. Keep in mind that we are painting with a broad brush. What is a Pacemaker? This week’s tidbit is on pacemakers. […]

  • ICD-10-CM/PCS – Part 69: Question & Answer

    Author: Linda Kobayashi, BA, RHIT, CCS Editor: Andrea Wong, BS, RHIT Happy New Year Everyone! Let’s get off to a good start with ICD-10. We hope you’re finding it a little easier now that you’ve had some experience tucked under your belt. We have been discussing the Circulatory System and will continue to do so […]

  • ICD-10-CM/PCS – Part 68: Question & Answer

    Author: Linda Kobayashi, BA, RHIT, CCS Editor: Andrea Wong, BS, RHIT For the past three weeks, we have addressed orthopedics. Its impossible to cover everything and that has never been our intention. We are giving you a broad overview of various body systems. For the next month we will be addressing the cardiovascular system. Problem […]

  • ICD-10-CM/PCS – Part 67: Question & Answer

    Author: Linda Kobayashi, BA, RHIT, CCS Editor: Andrea Wong, BS, RHIT This week we are going to continue our discussion on orthopedics and hip replacement surgery. How are you coders coping with ICD-10? We’d love to hear from you, as you could benefit from each other as well as us. If we know what is […]

  • ICD-10-CM/PCS – Part 66: Question & Answer

    Author: Linda Kobayashi, BA, RHIT, CCS Editor: Andrea Wong, BS, RHIT We began a discussion of orthopedic surgery with the 11/3 tidbit, spinal fusion. This week we are going to continue our discussion on fusion. Problem for this week: The patient, a 25-year-old man, was a passenger in a motor vehicle accident involving collision with […]

  • ICD-10-CM/PCS – Part 65: Question & Answer

    Author: Linda Kobayashi, BA, RHIT, CCS Editor: Andrea Wong, BS, RHIT Hi there Busters. If anyone would like to share his or her ICD-10 experiences, with us, we’d love to hear from you. We haven’t addressed orthopedic problems for quite a while and for sure, we haven’t addressed spinal procedures. Today we are going to […]