Mr. Yates experiences a sudden chest pain; EMS direction time and critical care in ED; CPR time included. What are the appropriate procedure codes?

Mr. Yates experiences a sudden chest pain; EMS direction time and critical care in ED; CPR time included. What are the appropriate procedure codes?

• A. 99291, 99288
• B. 92950, 99291, 99288
• C. 92950, 99291
• D. 99291, 99292, 99288

Answer: (B)

When a patient experiences sudden chest pain with in-field EMS direction and then receives critical care in the ED, you bill components for both the resuscitation and the hospital evaluation/management. The CPR performed is a separate procedural service, coded with 92950. The ED physician’s time providing life‑sustaining care falls under critical care codes, with 99291 used for the initial segment (the first 30 to 74 minutes of critical care). In addition, the ED evaluation and management of a patient in a life-threatening emergency requiring high-level decision making is captured with 99288. The EMS direction time in the field is encompassed in the overall resuscitation/critical care activities and is not billed separately. Why this set fits: 92950 accounts for the CPR itself; 99291 represents the initial critical care provided in the ED; 99288 reflects the high-level ED evaluation/management during this life-threatening situation. If the critical care time exceeded 74 minutes, you’d add 99292 for the additional minutes; if there’s no additional time beyond the first 74, 99292 isn’t used.

When a patient experiences sudden chest pain with in-field EMS direction and then receives critical care in the ED, you bill components for both the resuscitation and the hospital evaluation/management. The CPR performed is a separate procedural service, coded with 92950. The ED physician’s time providing life‑sustaining care falls under critical care codes, with 99291 used for the initial segment (the first 30 to 74 minutes of critical care). In addition, the ED evaluation and management of a patient in a life-threatening emergency requiring high-level decision making is captured with 99288. The EMS direction time in the field is encompassed in the overall resuscitation/critical care activities and is not billed separately.

Why this set fits: 92950 accounts for the CPR itself; 99291 represents the initial critical care provided in the ED; 99288 reflects the high-level ED evaluation/management during this life-threatening situation. If the critical care time exceeded 74 minutes, you’d add 99292 for the additional minutes; if there’s no additional time beyond the first 74, 99292 isn’t used.