Click here for more sample CPC practice exam questions with Full Rationale Answers

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Click here for more sample CPC practice exam questions and answers with full rationale

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Click here for more sample CPC practice exam questions and answers with full rationale

Clinical Examples for 99285


Emergency department visit for a patient with a complicated overdoes requiring aggressive management to prevent side effects from the ingested materials.  

Emergency department visit for a patient with a new onset of rapid heart rate requiring IV drugs. 

Emergency department visit for a patient exhibiting active, upper gastrointestinal bleeding.

Emergency department visit for a previously healthy young adult patient who is injured in an automobile accident and is brought to the emergency department immobilized and has symptom compatible with intra-abdominal injuries or multiple extremity injuries. 

Emergency department visit for a patient with an acute onset of chest pain compatible with symptoms of cardiac ischemia and/or pulmonary embolus. 

Emergency department visit for a patient who presents with a sudden onset of ‘’the worst headache or her life,” and complains of a stiff neck, nausea, and inability to concentrate.  

Emergency department visit for a patient with a new onset of a cerebral vascular accident.  

Emergency department visit for acute febrile illness in an adult, associated with shortness of breath and an altered level of alertness.  


Coding Ahead

can we bill 99285

Dear All:
Greetings

i have one query for the emergency department visit as patient brought by ambulance to our facility in a comatose state history was unobtainable,only comprehensive PE,comprehensive MDM is there.Patient was not admitted but transfer after 2 hours two other facility.For emergency E&M can we bill this case as 99285.Need advice

Medical Billing and Coding Forum

chest pain 99284 vs 99285

Hello all,

Having trouble with 99284 vs 99285 decisions for discharged ED patients who present with chest pain. They’ve had a full workup (labs including troponin, CXR, EKG may be independently reviewed) and are sometimes treated with pain meds. It is difficult to tell if the CP is ‘compatible with symptoms of cardiac ischemia and/or pulmonary embolus’. The discharge diagnosis is generally chest pain. I am not sure if these patients are MDM moderate or high risk. What should I be looking for to support a level 5?

In the cases I am coding the patients are not admitted to IP or observation. I appreciate your thoughts. Thank you

Medical Billing and Coding Forum