Working in a fast-paced emergency department (ED) is stressful on everyone involved, even the coder. An expert ED coder is fluent with current coding practices plus the unique rules that apply to this fast-paced environment. Depending on the situation and the payer, there are special rules that apply. As a certified coder in an ED, you stay up-to-date with this specialized coding. One way to demonstrate you are an expert ED coder is by earning certified professional coder-ED (CPC-ED®) credential.

Sarah Todt, RN, CPC, CPC-ED, audit manager for MRSI, Inc., believes her CPC-ED credentials helped her career. Todt said, "I obtained my credentials to qualify my expertise in the field. I take pride in the fact that I am a specialized coder in the field of emergency medicine. I do a lot of quality assurance activities and the credentials help validate my knowledge."

Jump into ED Coding

Earning the American Academy of Professional Coders' (AAPC) CPC credential shows you have a strong knowledge base and proves you are a medical coder who has achieved a measurable level of expertise in reviewing and adjudicating coding of services, procedures and diagnoses on medical claims; however, being an ED coder you may wish to take your specialized coding knowledge to the highest level by earning CPC-ED.

When coding or billing in the ED you may need to look up the proper codes for electrocardiograms and chest X-rays, and then the next minute need to be fluent in superficial wound repair and critical care codes. CPC-ED credentials shows you know the ins and outs of current ED coding and provides you with expert status to stabilize even the most wobbly claims.

Finding the answer to ED coding challenges can be frustrating. You may find yourself asking, "Is it appropriate for a hospital to bill a visit code under the OPPS for care provided to a registered outpatient if the patient was not seen by a physician?" or "What services are included in CPT code 99291 Critical care, evaluation and management of the critically ill or critically injured patient; first 30-74 minutes?" If these are just two of the pressing questions you have in the ED, AAPC can help you find the answers at http://www.aapc.com/memberarea/forums/index.php.

Validate ED Coding Skills Through AAPC

The AAPC's Specialty Study Guide: Emergency Department will help you prepare for the ED specialty credential examination. You can find it at http://www.aapc.com/onlinestore/item-details.aspx?pid=5|19|82&id=333.

When taking the exam Todt says, "Understanding the nuances of ED coding" is key. "There are many different procedures that may be performed and a good understanding of them is essential."

Based on Todt's experience taking the exam and working in the ED, her advice to coders who want to do the same is "Know your books. Be familiar with outpatient diagnosis coding rules as they are different from inpatient diagnosis coding. Also be aware that there is a lot of gray in the coding world. Follow the rules, but be flexible in thoughts as there may be room for interpretation on some topics."

Once you study and take the ED specialty test, you'll know which HCPCS Level II codes are used by provider-based outpatient hospitals to report Type A and Type B hospital ED visits and which are used for reporting hospital outpatient clinic visits; and coding ultrasound procedures performed in the ED will be a breeze.

To learn more about specialty certification, go to: http://www.aapc.com/certification/specialty-credentials.aspx.

Brad Ericson, CPC, CPC-ORTHO, is director of publications at AAPC and has been writing and editing coding publications for 16 years.