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Printed Date: 9/22/2015
Yes. Any physician seeing a patient registered in the emergency department (ED) may use ED visit codes for services matching the code description. It is not required that the physician be assigned to the ED. If the patient is admitted by this provider, the initial hospital service (CPT codes 99221-99223) with the AI HCPCS modifier would be submitted instead of the ED visit codes. Please keep in mind the service must be medically necessary and the documentation must meet the level of complexity of the service rendered.
The following guidelines apply to the ED CPT codes 99281 through 99285 billing:
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Last Updated: 12/01/2015
Applies to: Railroad Medicare, Railroad Medicare,
Article Topics: Appeals, Redeterminations, and PTANs