Answer :
Final answer:
It is false that all ED patients are considered new patients needing 3 of 3 elements to determine the ED level for billing. ED codes are based on complexity, decision making, and medical necessity, ignoring the 'new' or 'established' criteria.
Explanation:
The statement that all Emergency Department (ED) patients are considered new patients requiring 3 of 3 elements on the coding table to select the overall ED level for billing is false. In the Emergency Department setting, codes are selected based on the level of complexity, decision making, and medical necessity of the encounter rather than classifying patients as 'new' or 'established'. The Emergency Department Evaluation and Management (E/M) coding guidelines specify that code level selection is not dependent on the new or established patient criteria, which is usually relevant for office or other outpatient visits. The correct billing level is determined by the nature of the presenting problem, the physician's work involved, the required documentation, and the medical decision making or time spent with the patient. Providers must ensure that they meet the documentation requirements as per the relevant guidelines in order to bill accurately for ED services.
