CPT code 99283 is a Current Procedural Terminology (CPT) code used to describe the evaluation and management (E/M) of a patient in an emergency department (ED) setting. Specifically, it is used to describe a level 3 ED visit, which is a moderately severe presenting problem that requires prompt attention from the medical staff.
When to Assign ED Level 3 – CPT Code 99283
The following are the criteria that must be met in order to assign CPT code 99283 for a level 3 ED visit:
- Patient history: The patient history should include a brief review of the patient’s chief complaint, the patient’s relevant past medical history, and any other pertinent history.
- Physical examination: The physical examination should include a brief review of the patient’s overall appearance, vital signs, and an evaluation of the affected area or organ system.
- Medical decision-making: The medical decision-making should be of moderate complexity, meaning that the physician must consider two or more diagnoses or treatment options, and must use clinical judgment to determine the appropriate course of action.
- Time: The physician must spend at least 30 minutes in direct patient care. This includes the time spent reviewing the patient’s history, performing the physical examination, and making the medical decision.
Examples of Level 3 ED Visits – CPT Code 99283
The following are examples of level 3 ED visits that would warrant the use of CPT code 99283:
- A patient presents to the ED with a moderate asthma attack. The physician reviews the patient’s history, performs a physical examination, and administers nebulizer treatments. The physician spends 35 minutes in direct patient care.