Wiki Facility E/M clarification

[taneckapoe]

I have a question to see if someone can clarify verbiage on the ACEP tool finding the correct Facility level. Using the ACEP tool Level 5 says Prep for special imaging study (CT, MRI, US, VQ scans) combined with Multiple test or parenteral meds or oral or IV contrast. What do you consider multiple test?

Say patient had
1. labs, EKG, CT done (no contrast or parenteral meds) would you warrant this a level 4 or would the labs and EKG be consider "multiple test"?

I understand if Labs, EKG, CT with contrast or parenteral meds we can take to level 5 but the Multiple test isn't defined so wondering anyone can tell me what they do for the multiple test? Would you say if they had special screening done and any other diagnostic study (more than one) or multiple labs we can automatically take to level 5 due to "multiple test"?

Thanks

 

[jsz123]

If you are only using the Possible Interventions from the ACEP guidelines, my facility would consider your example a 99284 without any contrast or parenteral meds. A 99285 for my dept is multiple labs, special img studies w/contrast, and parenteral meds (not just hydration)

My facility has adapted the ACEP guidelines (with permission) for our specific use so that might be something you would look into. It certainly helps with our coders having clarification for ED leveling.

 

[taneckapoe]

Thanks. yes we follow the ACEP guidelines - and if meds or contrast given with scenario above it be a 5. I was wondering what you do for the Multiple test. Does Labs, EKG, and CT without contrast or meds given warrant a level 5 as the Labs and EKG are the multiple tests? If CT and Labs only it would be level 4 as "multiple tests" not done?

This is under 99285 on ACEP guidelines....
Prep for special imaging study (CT, MRI, Ultrasound, VQ scan) combined with multiple tests or parenteral medication or oral or IV contrast.