Putting It All Together Objective Criteria for Emergency Medicine E/M Code Choice

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The CPT Manual defines E/M level four or E/M code 99284 as:

A high severity case that poses an immediate threat to the patient’s life or physiologic function

A moderate severity case

A high severity case that does not pose an immediate threat to the patient’s life or physiologic function

A case that starts as a moderate level of risk and then moves to a high level of risk during the course of treatment of the patient

A patient visit for an isolated complaint requiring no neurological, rectal, pelvic, breast, or external genitalia exam, and no prescription on discharge would generally start at which of the following E/M levels:

E/M Level 99281

E/M Level 99282

E/M Level 99283

E/M Level 99284

A patient visit requiring a surgical consult would generally start at which of the following E/M Levels:

E/M Level 99281

E/M Level 99282

E/M Level 99283

E/M Level 99284

A patient visit requiring order and administration of one dose of Albuterol would generally start at which of the following E/M levels:

E/M Level 99281

E/M Level 99282

E/M Level 99283

E/M Level 99284

A patient visit requiring one isolated x-ray series of the hip and pelvis would generally start at which of the following E/M levels:

E/M Level 99281

E/M Level 99282

E/M Level 99283

E/M Level 99284

A patient visit requiring a PICC line evaluation and flush would generally start at which of the following E/M levels:

E/M Level 99281

E/M Level 99282

E/M Level 99283

E/M Level 99284

A patient visit requiring three labs and one x-ray would generally start at which of the following E/M levels:

E/M Level 99281

E/M Level 99282

E/M Level 99283

E/M Level 99284

Which of the following patient dispositions would generally start at E/M level 99285:

To the operating room from the ED with medical or traumatic condition requiring surgery with stable vitals

Most admissions and transfers

Rape and elder abuse cases

All of the above

A patient presents to the ED with severe abdominal pain requiring an Ultrasound and a CT scan of the abdomen. This encounter would generally start at which of the following E/M Levels:

E/M Level 99285

E/M Level 99284

E/M Level 99283

E/M Level 99282

True or False: Administration of medications that fall in the High risk category guarantees a E/M level 5 (99285) case.

True

False

Putting It All Together Objective Criteria for Emergency Medicine E/M Code Choice – Part 3