HPI-need 4 HPI elements for 99285 need 4 HPI elements for 99285
With 3 or less go down to 99283 With 3 or less go down to 99283
ROS-need 10 ROS for level 99285 need 10 ROS for level 99285
If 2-10 go down to 99284 10 go down to 99284 99285
Physical Exam-need 8 systems for 99285
If <8 go down to 99284
Past/Family/Social Past/Family/Social- need 2 for 99285 need 2 for 99285
If just one go down to 99284
99285 Acuity Caveat
99285 ED visit for the evaluation and
management of a patient, which requires these
three key components three key components within the constraints within the constraints
imposed by the urgency of the patient imposed imposed by the urgency urgency of the patient s patient s' clinical clinical clinical
condition and/or mental status
Severe Dyspnea Dyspnea - COPD, Asthma Pneumonia COPD, Asthma Pneumonia
Unstable Vital Signs Unstable Vital Signs- Trauma, Sepsis Trauma, Sepsis
Severe Pain - Long bone fractures open
45
Severe Pain - Long bone fractures fractures, open
fractures
CPR/intubated intubated
Should state on chart: Hx/Exam limited by____
