AMA CPT® Assistant - 2022 Issue 9 (September)
Emergency Department Services: Changes for 2023 (September 2022)
September 2022 pages 6-12 Emergency Department Services: Changes for 2023 As part of the effort to standardize reporting guidelines and structure for all of the codes throughout the Evaluation and Management (E/M) Services section of the Current Procedural Terminology (CPT®) 2023 code set, emergency department (ED) services codes 99281-99285 have been revised to more closely align with the 2021 changes for Office and Other Outpatient Services. These revisions ensure that physicians, staff, and other stakeholders will have a consistent set of general guidelines for all codes in the E/M section, although specific subsections may contain additional guidance related...
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Article Overview
This premium coding article explains how CPT 2023 revised emergency department evaluation and management services and how those revisions affect reporting in the ED and in related same-day scenarios. It is intended for coders, billers, physicians, and other qualified health care professionals who need to understand the updated structure, the service-level framework, and the broader implications for linked E/M guidance. The article also discusses how the changes interact with critical care reporting, pediatric and neonatal critical care, and certain procedures performed in the emergency department.
Why This Topic Matters
Emergency department E/M reporting changed substantially for CPT 2023, and accurate code selection depends on understanding the updated guidelines and how they align with other E/M subsections. The article is useful for minimizing reporting errors and for recognizing when related services may be reported on the same date of service.
Article Sections
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September 2022 pages 6-12
Introductory material identifying the publication span covered by the article.
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Emergency Department Services: Changes for 2023
Overview of the 2023 updates to emergency department evaluation and management services and how the revisions fit within the broader CPT E/M restructuring.
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Summary of Changes
General discussion of the updated emergency department service framework, including the revised approach to selecting service levels and related reporting considerations.
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Critical Care and ED Services
Discussion of same-day emergency department and critical care reporting, including circumstances tied to changes in the patient’s condition.
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Services Performed by Other Physicians and Other QHPs in the ED
Coverage of emergency department reporting considerations for services performed by physicians and other qualified health care professionals who are not ED staff.
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Pediatric ED and Critical Care Services
Discussion of pediatric and neonatal critical care reporting in relation to emergency department services and transfer-related scenarios.
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Table 1. Emergency Department Services’ MDM Levels Summary
A comparative summary of the emergency department service levels and the associated medical decision-making framework across the cited CPT years.
What You Will Learn
- How CPT 2023 changed the structure of emergency department evaluation and management services
- Which topics are covered in the revised emergency department reporting guidance
- How the article addresses service-level selection and related emergency department considerations
- How the article discusses same-day emergency department and critical care reporting
- How pediatric and neonatal critical care issues relate to emergency department services
Who Should Read This
- Medical coders
- Billing staff
- Physicians
- Other qualified health care professionals
- Revenue cycle teams
Codes Discussed
Code Ranges Discussed
Modifiers Discussed
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