A 32 year old male comes to the ED complaining of low back pain. A lumbar CT scan is completed. He is given an injection of an anti-inflammatory and is discharged home. Below is a subset of the claim that was submitted for this visit.
|Age:||32||External Cause of Injury Diagnosis Code:||None|
|Gender:||Male||Principal Diagnosis Code:||M51.26, Other intervertebral disc displacement, lumbar region|
|Reason for Visit Diagnosis Code:||M54.5, Low back pain||Secondary Diagnosis Codes:||
|Diagnostic Procedure Code:||72131, Computed tomography, lumbar spine; without contrast material|
This total weight falls into the weight range used by the EDC Analyzer™ for a visit level 4. As such, the EDC Analyzer™ would recommend that the ED visit code on this claim be 99284 or G0383.