Health Information Management

Tip: Know which type of ED your facility operates

APCs Insider, November 5, 2010

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Which type of ED your facility operates will determine which codes you assign. EDs are classified as type A EDs and type B EDs. A type A ED is:

  • Available 24 hours a day, seven days a week
  • Licensed by the state in which it is located under applicable state law as an ED or held out to the public (by name, posted signs, advertising, or other means) as a place that provides care for emergency medical conditions on an urgent basis without requiring a previously scheduled appointment

Type A EDs use CPT codes 99281–99283 with status indicator V (clinic or ED visit) and codes 99284–99285 with status indicator Q3 (codes that may be paid through a composite APC).

A type B ED is a dedicated ED and must meet one of the following conditions:

  • Is licensed by the state in which it is located under applicable state law as an ED
  • Is held out to the public (by name, posted signs, advertising, or other means) as a place that provides care for emergency medical conditions on an urgent basis without requiring a previously scheduled appointment
  • Provides at least one-third of all of its outpatient visits for the treatment of emergency medical conditions on an urgent basis without requiring a previously scheduled appointment

Type B EDs report HCPCS codes G0380–G0383 with status indicator V and G0384 with status indicator Q3, which means the code may be paid through a composite APC when composite-specific criteria are met. Type B EDs are not required to be open 24 hours a day.

This tip was adapted from “Consistent criteria critical for assigning ED visit levels” in the October issue of Briefings on APCs.



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