How To Use CPT Code 99288

CPT 99288 refers to the physician or other qualified health care professional direction of emergency medical systems (EMS) emergency care, advanced life support. This article will cover the description, procedure, qualifying circumstances, usage, documentation requirements, billing guidelines, historical information, similar codes, and examples of CPT 99288.

1. What is CPT 99288?

CPT 99288 is a code used to describe the medical direction provided by a physician or other qualified health care professional for a patient’s care via a two-way radio with emergency medical services (EMS) personnel in the field, or during transport to or from the emergency department. This code is used for the supervision of care by an emergency or control provider to the EMS staff outside the facility for an unstable patient requiring advanced cardiac or trauma life support.

2. 99288 CPT code description

The official description of CPT code 99288 is: “Physician or other qualified health care professional direction of emergency medical systems (EMS) emergency care, advanced life support.”

3. Procedure

The 99288 CPT code procedure involves the following steps:

1. Provider receives a call from EMS personnel regarding a patient requiring advanced life support.
2. Provider assesses the patient’s condition based on the information provided by EMS personnel.
3. Provider gives medical direction to EMS personnel on the appropriate care and interventions for the patient.
4. Provider continues to communicate with EMS personnel throughout the transport of the patient to the emergency department or other facility.
5. Provider documents the medical direction provided and any relevant patient information.

4. Qualifying circumstances

Eligibility for CPT code 99288 services depends on the following qualifying circumstances:

• The patient is unstable and requires advanced cardiac or trauma life support.
• The provider is a physician or other qualified health care professional capable of providing medical direction for advanced life support.
• Medical direction is provided via a two-way radio with EMS personnel in the field or during transport to or from the emergency department.
• The provider is not physically present with the patient during the transport.

5. When to use CPT code 99288

It is appropriate to bill the 99288 CPT code when a physician or other qualified health care professional provides medical direction for a patient’s care via a two-way radio with EMS personnel in the field, or during transport to or from the emergency department, and the patient requires advanced cardiac or trauma life support. This code should not be reported if the radio direction is for a patient who does not come to the emergency department where the provider is working, and there is no face-to-face encounter.

6. Documentation requirements

To support a claim for CPT 99288, the following information needs to be documented:

• Date and time of the medical direction provided.
• Details of the patient’s condition and the reason for requiring advanced life support.
• Specific medical direction given to EMS personnel, including any interventions or treatments advised.
• Duration of the medical direction and communication with EMS personnel.
• Confirmation that the provider was not physically present with the patient during the transport.

7. Billing guidelines

When billing for CPT code 99288, keep in mind the following guidelines and rules:

• Medicare and other payers frequently do not cover CPT 99288, as they consider it part of the preservice work of the E/M services in the emergency department or for an inpatient admission.
• Do not report CPT 99288 if the radio direction is for a patient who does not come to the emergency department where the provider is working, and there is no face-to-face encounter.
• Be aware of any payer-specific rules or requirements for billing CPT 99288.

8. Historical information

CPT 99288 was added to the Current Procedural Terminology system on January 1, 1992. The code was changed on January 1, 2013, with the previous descriptor being “Physician direction of emergency medical systems (EMS) emergency care, advanced life support.”

9. Similar codes to CPT 99288

Five similar codes to CPT 99288 and how they differentiate are:

• CPT 99466 and 99467: These codes are used for reporting transport of a critically ill or injured child younger than two years old requiring the provider’s attendance and direct face-to-face care during an interfacility transport.
• CPT 99485 and 99486: These codes are used for reporting supervision of interfacility transport care when there is no face-to-face care for the critical pediatric transfer, and the provider is directing emergency care through outside voice communication to transporting staff personnel.
• G0390: This code is used for reporting trauma response team activation associated with hospital critical care service, specifically requiring hospital notification by two-way radio.

10. Examples

Here are 10 detailed examples of CPT code 99288 procedures:

1. A patient experiencing a severe asthma attack requires advanced life support during transport to the emergency department. The provider gives medical direction to EMS personnel via two-way radio.
2. An unconscious patient with a suspected drug overdose requires advanced life support. The provider directs EMS personnel on appropriate interventions during transport to the emergency department.
3. A patient with a severe allergic reaction requires advanced life support. The provider gives medical direction to EMS personnel on administering epinephrine and other interventions during transport.
4. A patient with a suspected stroke requires advanced life support. The provider directs EMS personnel on appropriate interventions and monitoring during transport to the emergency department.
5. A patient experiencing chest pain and shortness of breath requires advanced cardiac life support. The provider gives medical direction to EMS personnel on administering medications and monitoring the patient’s condition during transport.
6. A patient involved in a motor vehicle accident with multiple injuries requires advanced trauma life support. The provider directs EMS personnel on appropriate interventions and monitoring during transport to the emergency department.
7. A patient with a suspected myocardial infarction requires advanced cardiac life support. The provider gives medical direction to EMS personnel on administering medications and monitoring the patient’s condition during transport.
8. A patient with a severe head injury requires advanced life support. The provider directs EMS personnel on appropriate interventions and monitoring during transport to the emergency department.
9. A patient experiencing a seizure requires advanced life support. The provider gives medical direction to EMS personnel on administering medications and monitoring the patient’s condition during transport.
10. A patient with a suspected pulmonary embolism requires advanced life support. The provider directs EMS personnel on appropriate interventions and monitoring during transport to the emergency department.