CPT E/M for Emergency Department Services

emergency department
an organized hospital-based facility that is open 24 hours a day for the provision of unscheduled episodic services to patients who present for immediate medical attention

Emergency Department Services – New or Established Patient
used by the ED physician to report E/M services provided to new or established patients in a hospital-based emergency department; requires 3 of 3 key components

Why time is not descriptive component for ED services?
because emergency department services are typically provided on a variable intensity basis that often involves multiple encounters for several patients over an extended period of time, which makes it difficult for the ED physician to accurate estimate face-to-face time with a specific patient

Coding of 99285
The code descriptor includes a specific exception to the 3 key components requirement that allows the coder to assign this code if:
1) the 3 key components are met or exceeded
2) when the urgency of the patient’s condition prevents the ED physician from completing all 3 key components and documentation supports the urgency of the patient’s condition

Rule for more than 1 physician sees patient in ED
The ED physician uses the Emergency Department Services code while the other physician(s) use the appropriated E/M service code (Office/Other Outpatient services or Office/Other Outpatient Consultations)

Emergency Department Services – Other Emergency Services
used by the ED physician to report physician-directed emergency care involving advanced life support while typically in 2-way voice communication with ambulance or rescue personnel outside the hospital

Coding of ED Services for a hospital facility
Emergency Department Services codes are also used by a hospital facility that provides the ED, but CMS allows the hospital to define its own content of service, provided that the hospital facility abides by their own definitions for these service codes.

Hospitals provide different services, for example inpatient and outpatient. Although both services are provided within the hospital and have obvious similarities there are also major differences. The codes used within each service are affected by the differences between the services. …

There are times when a person needs immediate medical attention or medical treatment due to major accidents or massive injuries. For example, when a person has a car accident and has lost a lot of blood, he or she has …

The damage caused by Hurricane Katrina was a very serious one and an eye opener to the emergency medical service providers and the fire department. Indeed it was the most powerful hurricane to have ever hit the United States. The …

According to the American College of Emergency Physicians (ACEP), every day, 300,000 Americans on average are treated in the country’s emergency department. These patients are treated for a variety of illnesses. However, according to the ACEP it is also important …

Logically, all patients should have an equal access to EMS. This is also true in managed care. This comprises the equipment and resources needed in caring for all emergencies. In relation to this policy, emergency physicians and other medical personnel …

When a patient presents for outpatient surgery (same day surgery), code the reason for the surgery as… the first-listed diagnosis (reason for the encounter), even if the surgery isn’t performed due to contraindication. When a patient is admitted for observation …

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