Codes for reporting evaluation and management (E/M) services in the emergency department (ED) are similar to those for reporting other E/M services with a few exceptions. These exceptions and payer policies often result in questions about coding of ED services.

Codes 99281–99285 represent care provided only in a 24-hour hospital-based facility that is organized to provide unscheduled episodic services to patients presenting for immediate medical attention. Immediate care in a physician’s office, an urgent care facility, or other outpatient setting is not reported with an ED visit code. Office or other outpatient codes (99201–99205, 99212–99215) are the most common codes for urgent E/M services in settings other than an ED. See “Coding for Special Services In and Out of the Office” elsewhere in this newsletter for discussion of codes that may support provision of care on an urgent or emergent basis by physicians not working in the...

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