Reimbursement

Observation Physician Coding FAQ

1. Do the Evaluation and Management (E/M) Guidelines apply to observation services? Yes, Observation services will use the E/M Guidelines. Of note, unlike emergency medicine, Observation codes are se...

Sample Letter for Special Services (CPT 99053)

Services Denied Based on ICD-10 Codes Sample Letter

Appeal for Bundling Separately Reportable Procedures with Critical Care Services 99291 Sample Letter

Concurrent Care Denials Sample Letter

Critical Care Service Denied in the ED Sample Letter

Downcoding of E/M Services Based on ICD-10 Diagnostic Code Sample Letter

Sample Appeal Letter for Bundling CPR (CPT code 92950) with ED E&M Services (CPT codes 99281 - 99285)

Sample Appeal Letter for Bundling Splints (CPT codes 29105-29130 and 29505-29515) with ED E&M Services (CPT codes 99281 - 99285)

Sample Letter for Medicare Carrier X-Ray-ECG Interpretation Denial

Lack of Recognition of CPT Modifier 25 Sample Letter

Sample Letter for Non-Medicare X-Ray-ECG Interpretation Bundled into Evaluation and Management Code

Electrical Cardioversion

Transvenous Pacing FAQ

Thoracotomy FAQ

Pericardiocentesis (Pericardial Aspiration / Pericardial Drain Placement) FAQ

Epistaxis FAQs

Endotracheal Intubation FAQs

Thoracostomy FAQ

Lumbar Puncture FAQ

Sample Letter for Ultrasound Denial with Bundling into E/M

Reimbursement

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ACEP First Look: CMS Data on Federal IDR Process Under the No Surprises Act

2023 Emergency Department Evaluation and Management Guidelines

ACEP Membership Fuels Legal Victories

Urgent Care E/M

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Leadership Development Program Application

Emergency Physicians Strongly Oppose Insurer Efforts to Deny or Avoid Fair Reimbursement

Moderate Sedation FAQ

Coding and Reimbursement

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Shared/Split Services Sample Letter

Medication Assisted Treatment (MAT) FAQs

2021 Medicare Physician Fee Schedule (PFS) and MACRA Quality Payment Program (QPP) Proposed Rule: ACEP’s First Take

Wound Repair

In-Hospital Emergency FAQs

Telehealth in Emergency Departments Post-COVID-19 Public Health Emergency FAQ

Billing and Coding for COVID-19 Care

CMS Approves the Use of ED E/M Codes for Telehealth

Coding Guidance for COVID-19

Incision and Drainage FAQ

EMTALA and Prudent Layperson Standard FAQ

Mental Health FAQ

Emergency Medicine Alternative Payment Models: Frequently Asked Questions

Advocating Against 2021 Medicare Cuts

Acute Unscheduled Care Model

ACEP4U: Federal Surprise Billing (Out-of-Network Billing) Advocacy

Medicare Reimbursement for Emergency Physicians

What Every Resident Needs To Know About Reimbursement

Rejected Codes by Payer FAQ

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2023 Medicare E/M Frequency Distributions

ICD-10 Eclampsia Vignette

ICD-10 Fight Bite Vignette

ICD-10 Headache Vignette

ICD-10 Pneumonia Vignette

ICD-10 Resources

ICD-10 Abdominal Pain Vignette

ICD-10 Back Pain Vignette

ICD-10 Chest Pain Vignette

ICD-10 Open Fracture Vignette

ICD-10 Sepsis Vignette

What Every Graduating Resident Needs To Know About Reimbursement

Emergency Medicine and Payment Reform

Top 20 ED Reimbursement Codes

Episode-Based Reimbursement

The Impact of Unreimbursed Care on the Emergency Physician

Reimbursement: Advanced Practice Providers

Incorrect Coding Audits Sample Letter

Evaluation and Management Documentation Requirements – CMS vs. CPT

CMS Final Rule on X-Ray/EKG Interpretations

Reimbursement: Compliance

Reimbursement: Diagnostic Interpretations

Templated Letters for Appealing Denied Claims

ED Facility Level Coding Guidelines

CMS (then HCFA) memo regarding X-Ray/EKG Interpretations in the ED

Medicare Carriers Manual Part 3 - Claims Process Transmittal No. 1566

Reimbursement: Documentation Guidelines

Coding and Reimbursement Pearls

Prudent Layperson Transparency/Bad Insurer Practices

Reimbursement FAQs

Surgical Package FAQ

Arthrocentesis & Injection FAQ

Cardiopulmonary Resuscitation (CPR) FAQ

Critical Care FAQ

Medical Decision Making And The Marshfield Clinic Scoring Tool FAQ

ED Evaluation and Management Documentation Requirements – CMS vs. CPT

HPI-ROS FAQ

Shared Services

NCCI-CCI FAQ

Orthopedic Fracture / Dislocation Management FAQ

Appealing Denied Claims FAQ

Diagnosis Coding and Sequencing FAQ

Assignment of Benefits

Vascular Access

Advance Care Planning

Pulse Oximetry Interpretation FAQ

Utilization Review FAQ

Modifier Dictionary FAQ

Recovery Audit Contractor (RAC) FAQ

Observation Care Payments to Hospitals FAQ

Ultrasound FAQ

RBRVS FAQ

Health Care-Acquired & Provider Preventable Conditions FAQ

Behavior Change Intervention FAQ

Scribe FAQ

Nerve Blocks (Digital, Dental, Peripheral, etc.) FAQ

ICD-10 FAQ

Medicare's Hospital Readmission Reduction Program FAQ

APC (Ambulatory Payment Classifications) FAQ

Telemedicine for Medicare Patients FAQ

X-Ray - EKG FAQ

NG Tube FAQ

Teaching Physician Guidelines FAQ

Special Service Code (99053) FAQ

Physician Reimbursement

Medicare, Medicaid & CHIP

1995 Documentation Guidelines FAQ