Hospital coders must develop and adhere to internal E/M coding guidelines and CPT guidance to accurately report visits to the ED. In addition, because ED coding encompasses professional and facility billing, they may need to scour provider documentation to determine the correct E/M service level for both bill types.
A case manager at a community hospital has a cancer patient who comes to the emergency department and requires hospitalization. The patient wants to transfer to the hospital where she goes for chemotherapy treatments, but due to busy flu season, that hospital has no beds.
This week's note from the instructor is the second in a two-part series that discusses the intricacies of Medicare's inpatient hospital lifetime reserve days benefit and the challenges associated with it.
