What is CPT® 99283?
CPT® 99283 is used to report an emergency department (ED) visit for the evaluation and management (E/M) of a patient with a problem of moderate severity. This code applies regardless of whether the patient is new or established, as ED codes are not differentiated by patient status.
When to Use CPT® 99283
Report CPT® 99283 when the patient presents to the emergency department with a condition that requires an expanded problem-focused history, an expanded problem-focused examination, and medical decision-making of moderate complexity. Typical cases may include moderate asthma exacerbation, abdominal pain, or lacerations requiring simple repair.
Key Components for Billing
- History: Expanded problem-focused
- Exam: Expanded problem-focused
- Medical Decision-Making: Moderate complexity
- Patient Status: Applies to both new and established patients
- Typical Time: Not time-based; determined by key components and severity
Documentation Tips
To ensure proper reimbursement for CPT® 99283, documentation should clearly reflect:
- The patient’s presenting problem and its moderate severity
- Key clinical findings from the expanded history and exam
- Differential diagnoses considered and the rationale for management decisions
- Any interventions performed (e.g., diagnostic tests, minor procedures)
Why Accurate Coding Matters
Accurate coding of ED visits like CPT® 99283 ensures compliance, prevents claim denials, and supports the financial health of your practice. In an emergency setting, precision also reflects the complexity of care delivered.
How OptiMantra Helps
OptiMantra supports emergency providers with fast, flexible charting tools that keep up with the pace of patient care. Customizable templates, streamlined workflows, and integrated documentation features help reduce errors, speed up chart completion, and support accurate, efficient claim submission—even during high-volume shifts.
Try OptiMantra for free here!
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