Medicare Compliance & Reimbursement - 2005 Issue 8
Reader Questions: Avoid 99293 for ED Care
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Article Overview
This reader Q&A explains a critical care coding question involving emergency department care for an infant transferred to another hospital. It is useful for coders working in emergency medicine, pediatrics, and inpatient critical care because it discusses CPT critical care and pediatric inpatient critical care code selection, as well as the distinction between ED and inpatient settings.
Why This Topic Matters
Correctly distinguishing emergency department critical care from inpatient pediatric critical care is important for accurate reporting, compliant code selection, and avoiding inappropriate use of age-based pediatric codes in the wrong setting.
Article Sections
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Question
A coding scenario is presented involving emergency department care for a critically ill infant, including transport-related events and a transfer to another hospital.
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Answer
The response identifies the relevant CPT critical care and pediatric inpatient critical care code categories and explains the setting distinction addressed by the article.
What You Will Learn
- How this reader question distinguishes emergency department critical care from inpatient pediatric critical care
- Which CPT critical care code categories are referenced in the discussion
- How age and care setting are framed in relation to the codes discussed
- Why this question is relevant to emergency medicine and pediatric coding review
Who Should Read This
- Medical coders
- Emergency department coders
- Pediatric coders
- Inpatient facility coders
- Coding auditors
- Revenue cycle professionals
Codes Discussed
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