A 37 year old female comes to the ED complaining of pain in her right foot and ankle. An X-ray is completed and a splint is applied. She is discharged home with a prescription. Below is a subset of the claim that was submitted for this visit.
|Age:||37||External Cause of Injury Diagnosis Code:||W10.9XXA, Fall (on) (from) unspecified stairs and steps, initial encounter|
|Gender:||Female||Principal Diagnosis Code:||S92.351A, Displaced fracture of fifth metatarsal bone, right foot, initial encounter for closed fracture|
|Reason for Visit Diagnosis Code:||M25.571, Pain in right ankle and joints of right foot||Secondary Diagnosis Code:||M25.571, Pain in right ankle and joints of right foot|
|Diagnostic Procedure Code:||73610, Radiologic examination, ankle; complete, minimum of 3 views|
This total weight falls into the weight range used by the EDC Analyzer™ for a visit level 3. As such, the EDC Analyzer™ would recommend that the ED visit code on this claim be 99283 or G0382.