Common emergency department diagnoses include: chest pain, shortness of breath, abdominal pain, trauma (such as from a fall or car accident), lacerations, fractures, pneumonia, asthma exacerbation, heart attack, stroke, and dehydration.
It also includes fever, flu-like symptoms, headache, and other common illnesses, as well as mental health issues such as anxiety and depression.
Insurance companies generally pay well for emergency diagnoses that are deemed medically necessary and justified. This can include serious conditions such as:
-Chest pain/heart attack
-Abdominal pain
-Shortness of breath
-Head injury
-Lacerations
-Fractures
-Sprains/strains
-Seizures
-Stroke
-Infections (e.g. pneumonia, urinary tract infection)
-Dehydration
-Drug overdose/poisoning
-Asthma/chronic obstructive pulmonary disease (COPD) exacerbation
-Allergic reactions
-Hypoglycemia (low blood sugar)
-Hypertensive crisis
It’s important to note that insurance reimbursement for emergency department visits and diagnoses can vary depending on the patient’s specific insurance plan, the state they live in, and the facility where they received care. Additionally, insurance companies may require prior authorization or additional documentation to support the medical necessity of the visit and treatment.
To learn more about Medical Billing and Coding Tips, here.
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