ED Coding and Reimbursement Alert

Question: Can I report an ED evaluation and management (E/M) code along with a code for cardiopulmonary resuscitation (CPR)? Or is CPR included in the ED E/M package?

Idaho Subscriber

Answer: Any patient who needs CPR would likely have received critical care services if the documented time threshold of 30 minutes had been reached.

Assuming they have not, as in this question, ED E/M code 99285 (Emergency department visit for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and high level of medical decision making) would be justified. Much like with critical care codes, you can report CPR separately from an ED E/M service. Report 92950 (Cardiopulmonary resuscitation (eg, in cardiac arrest)) for the CPR.

Important: You must separate the work included in the CPR from the ED E/M work before choosing a ED E/M code. Also, be sure to append modifier 25 (Significant, separately identifiable evaluation and management service by the same physician or other qualified health care professional on the same day of the procedure or other service) to the ED E/M code to show that it was a significant, separately identifiable service from the CPR.