AMA CPT® Assistant - 1995 Issue 2 (Summer)
Emergency Department Services (Summer 1995)
Summer 1995 pages 1-3 Emergency Department Services How Is Emergency Department Defined in CPT? Evaluation and management services provided in the emergency department are reported using codes from the Emergency Department Services section 99281-99285. As stated in CPT 1995, "An emergency department is defined as an organized hospital-based facility for the provision of unscheduled episodic services to patients who presents for immediate medical attention. The facility must be available 24 hours a day." A freestanding ambulatory facility or urgent care center visit is not considered an emergency department, based on the guidelines in CPT. If a patient presents...
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Article Overview
This article explains how CPT 1995 addresses emergency department services and related evaluation and management reporting issues. It is aimed at coding professionals, emergency department staff, and other physicians who need to understand the scope of ED services, how certain accompanying services are handled, and how related special service codes fit into the broader guidance. The article also touches on documentation, consultation, inpatient admission, critical care, diagnostic test interpretation, fracture care, and special services reporting.
Why This Topic Matters
Emergency department encounters often involve multiple services, multiple physicians, and overlapping reporting considerations. This article helps readers understand the general CPT framework that affects how emergency care and related services are described and documented.
Article Sections
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Summer 1995 pages 1-3
A broad overview of emergency department coding topics covered in this issue. The section introduces the main areas of guidance discussed in the article.
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Emergency Department Services
General guidance on emergency department evaluation and management reporting and the scope of services discussed in CPT 1995. The section also frames the article’s focus on emergency care coding issues.
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New and Established Patients
Discussion of patient status concepts within emergency department evaluation and management services. The section explains how the topic is addressed in the emergency department setting.
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Time in the Emergency Department
Overview of how time is treated in emergency department evaluation and management reporting. The section addresses why time is not emphasized in the same way as in other settings.
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Who Can Use These Codes
Guidance on which physicians may report emergency department evaluation and management services. The section covers situations involving multiple physicians and overlapping care settings.
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Coding Critical Care Services in the Emergency Department
Discussion of critical care reporting in the emergency department and how it relates to other services provided during the encounter. The section also addresses related reporting concepts and included services.
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Coding the Interpretation of Diagnostic Tests
Guidance on reporting diagnostic test interpretation in the emergency department. The section also discusses documentation and circumstances involving review of test results by more than one physician.
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Evaluation of a Fracture in the Emergency Department
Overview of fracture-related reporting considerations in the emergency department. The section discusses how fracture care guidance is presented in CPT and how it relates to emergency department evaluation and management.
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Special Services and Reports
Discussion of special services reporting and the historical context of selected adjunctive codes. The section notes how these services are discussed in relation to specialty use and payer policies.
What You Will Learn
- How CPT 1995 frames emergency department evaluation and management services
- How the article addresses patient status concepts in emergency department care
- How time is treated in emergency department reporting
- Which physicians may report emergency department services in shared-care situations
- How the article discusses critical care, diagnostic test interpretation, fracture care, and special services reporting
Who Should Read This
- Medical coders
- Billing staff
- Emergency department physicians
- Other treating physicians
- Compliance and revenue cycle staff
Codes Discussed
Code Ranges Discussed
Modifiers Discussed
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