AAPC - Back to school
Results 1 to 3 of 3

Thread: Emergency room cpt codes

  1. #1

    Default Emergency room cpt codes

    AAPC: Back to School
    If a doctor has admitting privledges to a hospital can they use the Emergency Room CPT codes? 99281, 99282 & etc? or do they have to be employed by the Emergency Room? At a CPC boot camp this weekend, the instructor said the doctor needs to be employed by the ED. Please help in clearing up this issue?

  2. #2
    Join Date
    Apr 2007


    The physician has to have privileges in the ED in order to treat patients in the ED. Without ED privileges, admitting privileges don't matter.... we have contract physicians who supply coverage for our ED, and we have physicians not part of that contract who also have privileges in the ED, and they bill for their services in the ED. If the physician has been granted privileges by the medical staff to treat patients in the ED, then they would have to use 99281-99291. Hope that helps!

  3. #3


    30.6.11 - Emergency Department Visits (Codes 99281 - 99288)
    (Rev. 1875, Issued: 12-14-09, Effective: 01-01-10, Implementation: 01-04-10)
    A. Use of Emergency Department Codes by Physicians Not Assigned to Emergency Department
    Any physician seeing a patient registered in the emergency department may use emergency department visit codes (for services matching the code description). It is not required that the physician be assigned to the emergency department.

    C. Use of Emergency Department Codes to Bill Nonemergency Services
    Services in the emergency department may not be emergencies. However the codes (99281 - 99288) are payable if the described services are provided.
    However, if the physician asks the patient to meet him or her in the emergency department as an alternative to the physician’s office and the patient is not registered as a patient in the emergency department, the physician should bill the appropriate office/outpatient visit codes. Normally a lower level emergency department code would be reported for a nonemergency condition.

    If your provider renders care in the ED and then admits the patient to inpatient status on the same DOS, only the initial hospital care service will be reimbursed.

Similar Threads

  1. emergency room cpt codes
    By ddebbied in forum Modifiers
    Replies: 2
    Last Post: 05-13-2016, 12:48 PM
  2. CPT codes in a Procedure Room
    By pochranek in forum Outpatient Facilities
    Replies: 2
    Last Post: 10-21-2014, 08:39 AM
  3. CPT code 92960 for the emergency room for cardioversion
    By tgdavid in forum Emergency Department
    Replies: 0
    Last Post: 06-15-2010, 05:19 PM
  4. Emergency Department Cpt Codes
    By NESmith in forum Emergency Department
    Replies: 1
    Last Post: 04-30-2010, 05:43 PM
  5. Emergency Room Codes 99281-99288
    By CrysLednum in forum Medicare Regulations
    Replies: 2
    Last Post: 01-07-2010, 01:12 PM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts

Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?


Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.