Emergency Room Coding Services

by | Jan 15, 2015 | Health

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Emergency room coding deals directly with issues surrounding billing and compliance. Professional coding services can provide emergency rooms with auditing and coding services for the claim of the facility, as well as the physician. Most of these services will provide audits of the facility and their documentation and reports. One of the most convenient factors of the coding spectrum is that coding can be carried out onsite or offsite if necessary. The coding team is made up of professional coding experts that have extensive knowledge in the area of coding and compliance regulations and how they apply to emergency room services. There are constant changes in the coding language and it’s imperative that all responsible for coding services are aware of these changes as they occur.

A Look at ER Coding

Whenever an emergency medical situation arises, the emergency room is typically the first place that people go. It’s the one location that specializes in urgent care in times of emergency and serious injuries. Many of these visits lead to admission of the patient, scheduled follow-ups or transfer to another facility. Emergency rooms are usually assigned a trauma level of 1-4, with 1 being the most sever. The state and available resources, along with the annual patient capacity are used to determine the level. Emergency room coders must be extremely accurate in a wide genre of diagnoses. Emergency rooms and physicians typically utilize different billing codes for similar or the same services.

The Guidelines of Coding

Emergency room coding specifics can become quite complicated especially since these guidelines are set forth by the hospital. There are differences in payment structure for the private physician sector versus the emergency room setting. Various and varying documentation is required at each level of treatment as a means to help correlate the method of treatment rendered and the diagnosis. There must be an exact documentation of all treatments and procedures performed in order for the emergency room to receive reimbursement for their services. Guarantee of payment weighs heavily on the accuracy in coding that is entered. Hospitals must assure that applicable rules are applied for assigned levels of treatment. Any emergency room is subject to audit of coding such as, technical, professionals, modifiers and E/M levels as well. All guidelines on coding techniques are set in place for accuracy and compliance assures timely payment on all claims that the emergency room processes.

Emergency Room Coding has a variety of coding guidelines that must be adhered to in order to file claims.  understands the importance of guideline adherence in the medical coding industry.

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