Question

question 18
a 25 - year - old male is brought by ems to the emergency department for nausea and vomiting. patient has elevated blood sugars and the ed provider is unable to get a history due to patients altered mental status. a medically appropriate exam is performed and the mdm is high. the patient was stabilized and transferred to icu under a different provider. the ed provider documents total critical care time 25 minutes. what cpt® coding is reported?
o 99223 - 25, 99291
o 99285 - 25, 99291
o 99291
o 99285

Explanation:

CPT (Current Procedural Terminology) codes are used to report medical, surgical, and diagnostic services. For critical - care services, specific codes are used based on the time spent. Since the patient had 25 minutes of total critical - care time and the ED provider documented it, the appropriate code for critical - care services with that time frame is considered. CPT code 99291 is used for the first 30 - 74 minutes of critical care. Code 99295 is for subsequent 30 - minute increments of critical care. In this case, as the time is 25 minutes, the code 99223 is for an emergency department visit with a detailed or comprehensive history and examination and medical decision - making of moderate complexity, but here the focus is on critical care. The correct code combination considering the situation is 99285 (emergency department visit) with 25 minutes of critical care time and 99291 (critical care initial service).

Answer:

C. 99285 - 25, 99291