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July 2002 · Vol. 14, No. 7

REIMBURSEMENT ADVISER

Gravidas in the ER

Q

It is our understanding that if a gravida is in the emergency room (ER) triage for less than 6 hours, we should bill an office visit/out-patient facility E/M code. Why not report an ER E/M visit unless the patient is admitted to observation status?

A

Multiple problems arise when using the ER E/M codes (99281 to 99285), making the office visit/outpatient facility E/M codes a better alternative (99201 to 99215).

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