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Ancillary coding

Ancillary coding

An emergency department (ED), also known as an accident & emergency department (A&E), emergency room (ER), emergency ward (EW) or casualty department, is a medical treatment facility specializing in emergency medicine, the acute care of patients who present without prior appointment; either by their own means or by that of an ambulance. The emergency department is usually found in a hospital or other primary care center.
Due to the unplanned nature of patient attendance, the department must provide initial treatment for a broad spectrum of illnesses and injuries, some of which may be life-threatening and require immediate attention. In some countries, emergency departments have become important entry points for those without other means of access to medical care.
Emergency Medicine presents a unique set of challenges for coding. This fast paced high-volume specialty encompasses elements of primary care E&M services up to trauma services. ... Their coding is done remotely, usually by billing companies or hospital medical records staff.
Delivering quality care, while ensuring effective clinical documentation and compliant medical coding is even more challenging in emergency departments, which are fast-paced environments spread across multiple specialties presenting unique medical coding and billing challenges. Alongside knowledgeable clinical staff, specialized medical coders and billers with the requisite experience and strong analytical skills are required to obtain necessary reimbursements.

  • Becoming a CPC demonstrates you have:
  • The nature of ED environment demands instant cognitive clinical decisions and shorter execution time. This means that the clinical documentation time available to providers is limited leading to high instances of discharges not fully billed and denied claims.
  • Timely Coordination of care between ED physicians and multiple faculty staffs and documentation of the same is pivotal for the coders to distinguish physician/professional services vs facility services rendered by nurses and ancillary staff.
  • Longer ED stays are often subject to scrutiny and audits. ED stays, longer than a day, require supporting medical necessity and a careful review of clinical documentation by coders to classify ED services vs observation care.