Interview Question for ED Facility
1.What is ED department?
An emergency department is defined as an organized hospital based facility for the provision of unscheduled episodic services to patients who present for immediate medical attention.
2.What are the code range for Emergency department visit?
99281 to 99285
3.Like E&M , is there any distinction for New and Established patient in ED ?
How to report new ED patient encounter ?
No distinction is made between new and established patients in the emergency department.
4.Is time as a factor in the emergency department setting?
Time is not a descriptive component for the emergency department levels of E/M services because emergency department services are typically provided on a variable intensity basis, often involving multiple encounters with several patients over an extended period of time.
5.What are the basic difference between 95 and 97 guidelines?
95 guidelines are based on the body systems while 97 systems based on bullet points.
6.What is critical care?
Critical care is the direct delivery by a physician(s) or other qualified health care professional of medical care for a critically ill or critically injured patient.A critical illness or injury acutely impairs one or more vital organ systems such that there is a high probability of imminent or life threatening deterioration in the patient’s condition.
7.What are the code range for critical care?
99221 to 99222
8. Which procedures are bundled in critical care ?
The following services are included in critical care when performed during the critical period by the physician(s) providing critical care:
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The interpretation of cardiac output measurements (93598),
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Chest X rays (71045, 71046),
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Pulse oximetry (94760, 94761, 94762)
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Blood gases, and collection and interpretation of physiologic data (eg, ECGs, blood pressures, hematologic data); gastric intubation (43752, 43753)
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Temporary transcutaneous pacing (92953)
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Ventilatory management (94002-94004, 94660, 94662)
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Vascular access procedures (36000, 36410, 36415, 36591, 36600).
9.What is the minimum time required to report critical care services?
30 min
10.What is the primary diagnosis?
The primary diagnosis refers to the main reason for the visit or the ongoing treatment.
11.What is the secondary diagnosis?
The secondary diagnosis includes additional conditions that may have impacted the treatment but were not the main reason for the visit.
12.What is upcoding and downcoding ?
Upcoding occurs when a higher level of service is reported than what was actually provided. This practice misrepresents the level of care given, usually in an attempt to increase reimbursement from insurance companies or government programs like Medicare.
Downcoding occurs when a lower level of service is reported than what was actually provided, leading to under-reimbursement for the services rendered.
13.Who is considered as qualified health care professional?
They are the individuals who is qualified by education, training, licensure/regulation who performs a professional service within his/her scope of practice and independently reports that professional service.
Examples of QHPs include: nurse practitioner (NP), certified nurse specialist (CNS), physician assistant (PA), clinical social worker (CSW), and physical therapist (PT).
14.What is minor and major surgery?
According to medicare, a major surgery has a global period of 90 days and minor surgery has a global period of either 10 or 0 days.
15.How do you report foreign body removal ?
If foreign body is removed without any incision or directly through forceps then we will code foreign body removal. If it is removed by making a incision then we will report based on the site of foreign body. If only some part of foreign body is removed then we have to use 52 modifer (Reduced procedure).
16. How to code burns ?
We neeed to check the documentation to find whether provider indicate that they did debridement or personally appying the silvadene dresssing.
17.What is cardioversion?
Cardioversion is a medical procedure that uses quick, low-energy shocks to restore a regular heart rhythm. It's a treatment for certain types of irregular heartbeats (arrhythmias), including atrial fibrillation (A-fib).
18.What is trigger point injection?
The injection of anesthetic or cortiosteroid substance in the trigger knot in the muscle or in the finger.
19.How you will code infusion and hydration given at the same time ?
20.What is the abbreviaton for CPR ?
Cardiopulmonary resuscitation
21.What is cerumen impaction?
Cerumen (ear wax) build up in the ear canal, which may lead to symptoms of discomfort, dizziness and impaired hearing for which patients seek medical care.
22. How to code mulitiple laceration repair of different body part ?
We have to sum the total length of repair of same type in same category
23.What is central venous access device CVAD?
Central venous access devices (CVADs) or central venous catheters (CVCs) are devices that are inserted into the body through a vein to enable the administration of fluids, blood products, medication and other therapies to the bloodstream
24.What is nerves Block?
A nerve block is the injection of a local anesthetic (numbing medicine) close to a particular nerve to lessen pain in that area of your body both during and after surgery.
25.What is paracentesis?
A procedure known as paracentesis involves inserting a needle or catheter into the peritoneal cavity in order to extract ascitic fluid for either medicinal or diagnostic uses. Ascitic fluid can be used to check for cancer or infections, as well as to help identify the cause of ascites.
26.Will you code bladder irrigation and Urinary foley catheter insertion at the same time performed in the same session?
No when bladder irrigation and Foley catheter insertion are performed on the same patient in the same session , so we have to code only Foley catheter insertion.
27.Patient is taking Fluticasone as nebulization, then how you will code long term out of below?Systemic TopicalInhaledWe will code inhalation as it is document says nebulization means taking through nasal.
28.What are place of service for ?
Emergency Outpatient Inpatient Emergency-23Outpatient - 22Inpatient - 21
29.What is SOAP?
S: SubjectiveO: ObjectiveA: AssessmentP: Plan
30.What is traumatic fracture and Non traumatic fracture?
The traumtic fracture means the fracture is due to some trauma or injury. But Non traumatic fracture means fracture is due to pathological fracture without having any injury.
31.What is the basic difference between emergency and outpatient department?
Outpatient department has status either new or established but for emergency there is no such things.
32.What is the difference between inpatient and outpatient?
Outpatient is the patient come and get treated and leave the same day. But inpatient is the patient gets admitted with a overnight stay,get treated and get discharge.So minimum 24 hour stay requires.
33.What is closed fracture and open fracture?
Closed fracture is one in which the fracture bone is not exposed to external envirornment whereas in open fracture the fracture bone is open to external environment.
34.What are the guidelines for coding complex I&D?
For coding complex I&D we need at least one of the following documentation in the operative notePacking with gauzeMultiple I&D procedureBlunt dissection to brearkup Loculation
35.What is Modifier ?
A modifier is a two digit number by which the reporting physician can indicate that a service or procedure that has been performed has been altered by some specific circumstance but has not changed in its definition or code.