CPT code 99283 is used to describe a Level 3 Emergency Department (ED) visit. This code is assigned when the patient presents with a problem that requires urgent evaluation by a physician, but the severity of the problem is not life-threatening.
According to the Centers for Medicare and Medicaid Services (CMS), the following criteria must be met in order to assign a Level 3 ED code:
- A detailed history must be obtained, including information about the patient’s chief complaint, the duration and severity of the problem, and any associated symptoms.
- A detailed examination must be performed, including a focused examination of the affected body system(s).
- Medical decision-making of moderate complexity must be involved, which includes consideration of the patient’s presenting problem, the complexity of any necessary diagnostic tests, and the risk of complications or morbidity.
If these criteria are met, then CPT code 99283 can be assigned to the ED visit. It’s important to note that the decision of which ED level to assign should always be based on the medical necessity of the services provided, and not on the patient’s diagnosis or the services rendered.