ED Coding Education: FAST Exams
Posted on 03. Dec, 2009 by in Hot Coding Topics
Watch It: If you fly through FAST exam coding, you could miss vital info
When your physician performs a FAST (focused assessment by sonography for trauma) examination, be sure to go through the notes slowly or you could miss one of the three common codes.
FAST exam patients are almost always in some physical trauma, which requires a high-level E/M service; once the physician makes the decision, she’ll perform a pair of procedures to complete the FAST exam.
Use this guide to correct coding so you’ll be quick on the draw when coding for trauma patients requiring FAST exams in your Emergency Department.
FAST Focuses on Trauma Patients
The high acuity of the ED setting is part of the reason that ED physicians perform their fair share of FAST exams; “Common presentations associated with internal bleeding include blunt trauma such as MVAs [motor vehicle accidents] and significant falls,” states Eli Berg, MD, FACEP, CEO of MRSI, an ED coding and billing company in Woburn, Mass.
During a FAST exam, the emergency physician is looking for a collection of fluid in the chest, abdomen, and pelvis, explains Greer Contreras, CPC, senior director of coding for Marina Medical Billing Service Inc. in California.
According to Jennifer K. Curry, clinical manager for the department of emergency medicine for UMDNJ-Robert Wood Johnson Medical School in New Brunswick, N.J., FAST exam candidates could include patients who have:
• suffered blunt trauma to the trunk/abdomen
• hypotension with abdominal pain
• severe abdominal pain radiating to the back (to rule out aortic dissection)
• abdominal pain with recent cardiac or vascular catheterization with access through the inguinal vascular system (to rule out retro peritoneal bleed).
Remember, Both FAST Codes Require 26
There are two steps to any FAST exam, confirms Curry.
Step 1: The physician...
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