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OPPS ED Payment Rates in 2013

    Medicare payment for OPPS Facility Evaluation and Management visit levels in the Emergency Department increased for all levels in CY 2013.  The CMS conversion factor used to determine payment has increased by $1.89 from 2012 to 2013.  The increase in payment appears to be due to a change in the way CMS averages costs. The 2013 Final Rule states that for OPPS & … read more

Why Hospitals Should Consider the Presenting Problem in their E&M Coding Algorithm

A patient’s presenting problem is an integral consideration to proper selection of the Emergency Department Visit Level and maintaining accurate coding principles.  The presenting problem is a window into the diagnostic complexity of an Emergency Department visit. It is also the intent of CPT©. While there are always exceptions, the average patient presenting for evaluation and … read more