# chest pain  99284 vs 99285



## ens555 (Aug 31, 2017)

Hello all,

Having trouble with 99284 vs 99285 decisions for discharged ED patients who present with chest pain.  They've had a full workup (labs including troponin, CXR, EKG may be independently reviewed) and are sometimes treated with pain meds.  It is difficult to tell if the CP is 'compatible with symptoms of cardiac ischemia and/or pulmonary embolus'.  The discharge diagnosis is generally chest pain.  I am not sure if these patients are MDM moderate or high risk.  What should I be looking for to support a level 5?

In the cases I am coding the patients are not admitted to IP or observation.  I appreciate your thoughts.  Thank you


----------



## nickelclaw (Sep 1, 2017)

Hello I do level four. Was recently told that if infused with pain meds  that have to be monitored then could use a 5.


----------

