Experience. Integrity. Advocacy.
Experience. Integrity. Advocacy.

Coding

What Do Higher Levels of Service Say About What’s Happening in the ED?

An 85 percent increase per member in emergency department spending between 2009 and 2015 was the result of hospitals coding and billing for a greater number of high severity cases, according to a 2017 Health Care Cost Institute study. But what does this upward shift in evaluation and management levels say about what’s happening in the ED? READ MORE

Medicare Denies Payment for Add-on Conscious Sedation Code

Physicians taking advantage of new unbundled codes for billing moderate or conscious sedation are receiving denials from Medicare for one of them. That code, 99153, which is the add-on code for additional time spent administering conscious sedation by a provider who’s also performing the primary service, has been denied by Medicare when the service was performed in a facility setting. READ MORE

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