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A 37 year old female presents to the ED with complaints of abdominal pain. Several lab services and a CT scan are performed. She is seen by a physician and discharged home. Below is a subset of the claim that was submitted for this visit.
Age: | 37 | External Cause of Injury Diagnosis Codes: | None |
Sex:* | Female | Principal Diagnosis Code: | R10.11, Right upper quadrant pain |
Reason For Visit Diagnosis Code: | R10.9, Unspecified abdominal pain | Secondary Diagnosis Codes: | None |
Diagnostic Procedure Codes: |
80053, Comprehensive metabolic panel
81001, Urinalysis dip stick/tablet reagent auto microscopy
85025, Blood count complete auto & auto differential WBC
74177, CT abdomen and pelvis with contrast
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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.