CPT 99284 describes an emergency department visit that involves a moderate level of medical decision-making, a medically appropriate history and/or examination, and the evaluation and management of a patient.
What Is CPT Code 99284?
CPT code 99284 is a code used to describe an emergency department visit that involves the evaluation and management of a patient.
This visit requires the medical professional to gather a medically appropriate history and/or perform a physical examination and engage in moderate-level medical decision-making.
Medical decision-making refers to considering various treatment options, ordering and interpreting diagnostic tests, and consulting with other medical professionals to ensure that patients receive the appropriate care for their condition.
A moderate level of medical decision-making is generally defined as involving a moderate number and complexity of problems, a moderate amount of data to review and analyze, and a moderate level of risk of complications, morbidity, and mortality related to patient management.
The CPT book describes CPT code 99284 as: “Emergency department visit for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and a moderate level of medical decision making.”
The provider meets with a patient in the emergency department to provide an evaluation and management (E/M) service.
During this visit, the provider engages in moderate complexity medical decision-making (MDM).
MDM involves considering various factors such as the number and complexity of the patient’s medical issues, the amount and complexity of data that needs to be reviewed and analyzed, and the potential risks of complications, morbidity, and mortality associated with the patient’s management.
To perform the E/M service, the provider may also take a patient history and perform a physical examination.
The provider determines the appropriate scope of the history and examination based on the patient’s specific needs and the visit’s purpose.
Overall, the provider assesses the patient’s needs and determines the best action to provide adequate care and manage the patient’s condition.