Editor’s Note: Cutting through the red tape to make certain that you get paid for every dollar you earn has become more difficult than ever, particularly in our current climate of health care reform and ICD-10 transition. The ACEP Coding and Nomenclature Committee has partnered with ACEP Now to provide you with practical, impactful tips to help you navigate through this coding and reimbursement maze.

Rapidly changing coding advisories keep coming as COVID-19 blazes its way across the United States. Here are some coding resources for various aspects of care related to COVID-19 patients.

Diagnosis of COVID-19: Providers should document whether the patient has suspected or confirmed COVID-19. In addition, document conditions related to COVID-19 such as acute respiratory distress syndrome, pneumonia, chronic obstructive pulmonary disease, asthma, or bronchitis. For more information, visit:

• www.acep.org/administration/reimbursement/covid-19
• www.cdc.gov/nchs/data/icd/COVID-19-guidelines-final.pdf

Telemedicine: The Centers for Medicare & Medicaid Services and the American Medical Association (AMA) provide guidance relating to who can manage a telemedicine encounter and where and how it may be managed during the COVID-19 emergency, with special information on the emergency department. Remember that you are still required to document your history and physical exam and medical decision making. For more information, visit:

• www.hhs.gov/sites/default/files/telehealth-faqs-508.pdf
• www.ama-assn.org/system/files/2020-04/covid-19-coding-advice.pdf (See Scenario 10 for ED telemedicine directions.)

EMTALA: EMTALA waivers are in effect during the COVID-19 pandemic. Some waivers include medical screening that may be set up off campus under hospital management. Communities may set up screening clinics at sites not under the control of a hospital under an EMTALA waiver. For more information, visit:

• www.cms.gov/files/document/qso-20-15-emtala-requirements-and-coronavirus-0311-updated-003pdf.pdf-1

Lab Testing: Current Procedural Terminology (CPT) code revisions were approved by the AMA to cover pathology and laboratory codes for SARS-CoV-2. This information is required to allow identification and payment for COVID-19-related problems. For more information, visit:

• www.ama-assn.org/system/files/2020-04/coronavirus-long-descriptors.pdf

The ACEP reimbursement website will be updated throughout the pandemic:

• www.acep.org/administration/reimbursement/covid-19

The ACEP Coding and Nomenclature Committee will continue to monitor all COVID-19-related coding and documentation advisories. For COVID-19 and general coding guidance, go to:

• www.acep.org/administration/reimbursement/reimbursement-faqs-1 

Brought to you by the ACEP Coding and Nomenclature Committee.

Ms. Edelberg is founder and chairman of Edelberg + Associates, faculty for ACEP Coding and Reimbursement Conference, an honorary member of ACEP, and chair of ACEP Coding and Nomenclature Advisory Committee (CNAC) Workgroup 4.