Emergency Room Billing CPT Codes 99281 – 99285

What is a CPT 99281 code?

It is a commonly used definition of an Emergency Department visit and is used in medical billing.

A 99281 CPT code is a visit that has three main components:

  • A problem-centric history.
  • A problem-centric exam.
  • Very simple medical decision making.
  • Usually, the symptoms the patient presents with are low urgency, requiring little to no immediate medical care. Some of the symptoms that fit under the 99281 code are self-treatable.

This low severity Emergency Room visit requires the least comprehensive chart notes.

 

What is CPT 99282 code?

It is a commonly used definition of an Emergency Department visit and is used in medical billing.

A 99282 CPT code is a visit that has three main components:

  • A longer problem-centric history.
  • A longer problem-centric exam.
  • Simple medical decision making.
  • Usually, the symptoms the patient presents with are low to moderate urgency, requiring low to moderate medical care. The severity is usually moderate to low. Some of the symptoms that fit under the 99282 code may not be self-treatable.

This low to moderate severity Emergency Room visit requires slightly more comprehensive chart notes.

 

What is CPT code 99283?

It is a commonly used definition of an Emergency Department visit and is used in medical billing.

A 99283 CPT code is a visit that has three main components:

  • A longer problem-centric history.
  • A longer problem-centric exam.
  • Moderately complex medical decision making.
  • Usually, the symptoms the patient presents with are moderately severe and urgent, requiring immediate care.

This moderate severity Emergency Room visit requires more comprehensive chart notes.

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What is CPT code 99284?

It is a commonly used definition of an Emergency Department visit and is used in medical billing.

A 99284 CPT code is a visit that has three main components:

  • A detailed problem-centric history.
  • A detailed problem-centric exam.
  • Moderately complex medical decision making.
  • Usually, the symptoms the patient presents with are of high severity, requiring immediate care but “does not pose an immediate significant threat to life or physiologic function”.

 

What is CPT code 99285?

It is a commonly used definition of an Emergency Department visit and is used in medical billing.

A 99285 CPT code is a visit that has three main components:

  • A high detail problem-centric history.
  • A high detail problem-centric exam.
  • Highly complex medical decision making.
  • Usually, the symptoms the patient presents with are of the highest severity, posing an immediate significant threat to life or physiologic function.

SOURCE: CPT 2011, CPT Assistant

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