Emergency Department Coding and Billing

Improve your ED coding, billing, and reimbursement process!

Does your ED coding and billing feel like a balancing act?
The emergency department (ED) is one of the most difficult places for hospitals to maintain compliant billing and coding procedures. You must balance your compliance obligations against patient care concerns, limited resources, and the frantic pace of the ED.

From the moment a patient steps into the ED until the final bill for the visit has been processed, there are countless opportunities for hospitals to lose legitimate revenue. To prevent losses of hundreds of thousands of dollars and reduce the risk of a government audit, it is crucial for EDs to operate efficiently with accurate charges, coding mechanisms, and appropriate documentation.

Practical guidance for proper coding and billing of ED services
The new book and CD-ROM set, Emergency Department Coding and Billing: A Guide to Reimbursement and Compliance, will help you improve the coding, billing, and reimbursement process for your hospital's ED and the physicians who staff it. At over 200 pages, it zeroes in on ED topics that affect accurate documentation, complete reimbursement, and compliance, offering advice on:

• Resource Based Relative Value System (RBRVS) and APCs
• Modifiers
• E/M coding and physician documentation
• Policies and procedures
• EMTALA

Detailed case studies provide real-life solutions to ED coding, billing, and reimbursement challenges
Emergency Department Coding and Billing is packed with 89 right-to-the-point case studies to support and explain the information in the book. Highlighted throughout the book, these instructive scenarios are easy to spot. They include procedure coding tips for hospital and physician billing for wide-ranging cases such as these:

• Suture technician services
• Opt-out physician provides services
• Laboratory encounter with patient collapse
• Inpatient to outpatient services
• ER physician performs workup (E/M) and the specialist performs endoscopic procedure
• Urgent care clinic point of service
• Sprained Index Finger
• Delineating surgical charges
• Rabies injections
• Crutches, canes, and walkers in the ED

The ED compliance information you need is just a click away with the included CD-ROM
The CD-ROM component of Emergency Department Coding and Billing provides complete regulations and Internet links for research into various coding, billing, and reimbursement issues and associated compliance issues. Organized by major topic areas, the CD-ROM includes a Special Topics section for specific issues that concern coding and billing in hospital EDs.

You're not buying a book, you're making an investment
Emergency Department Coding and Billing will include annual updates to keep you in-step with the latest cutting-edge practices and regulations affecting your ED coding, billing, and reimbursement. These will be delivered to you automatically, for a small fee. You'll have the opportunity to start benefiting from these right away or return them with no obligation.

Table of contents at a glance

Part I - The Business of Emergency Services
ED services
ED structure
Management, accounting, and documentation in the ED

Part II - Coding, Billing, and Reimbursement for the ED
Coding system and claim forms
Payment systems
Coding and billing for ED services
Fees, chargemasters, and charge capture

Part III - Compliance Issues for the ED
EMTALA
Developing an ED compliance plan

Who should read this book?

• Compliance personnel
• ED coding and billing staff, technicians, practitioners, administrators, and managers
• ER nurses and physicians
• Anyone interested in the financial process of coding, billing, and reimbursement for the ED

About the Author
Duane C. Abbey, Ph.D., CFP, is a management consultant and president of Abbey & Abbey, Consultants, Inc., of Ames, Iowa. The firm specializes in healthcare consulting and related areas. He is a cofounder of The HealthCare Consulting Group, a multi-state group of healthcare consultants.

Dr. Abbey has over 24 years experience as a consultant, with engagements revolving around a combination of compliance reviews, chargemaster reviews, APC implementation planning, and revenue enhancement for hospitals, hospital systems, and associated clinics. He is also a Certified Financial Planner, with expertise to review the financial records, business structure, organizational development, and related concerns of an organization. 

In addition to his consulting practice, Dr. Abbey teaches workshops and makes presentations on a regular basis to hospital associations, medical societies, and professional societies such as HFMA chapters and AAHAM.

Dr. Abbey earned his graduate degrees at the University of Notre Dame and Iowa State University.

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