ED Coding and Reimbursement Alert

Question: What are the documentation requirements to report 99288? Is the documentation by EMS personnel enough?

Indiana Subscriber Answer: No, to report 99288 (Physician direction of emergency medical systems [EMS] emergency care, advanced life support) you'll need documentation from the physician that he participated in the supervision of the EMS care of the patient.

Frequently in situations when you use 99288, the physician is in a hospital emergency department and is in two-way voice communication with ambulance or rescue personnel outside the hospital.

The physician should document in the patient's medical record his participation in and supervision of the EMS care of the patient. This may include some of the following services: 
  telemetry of cardiac rhythm   
  cardiac and/or pulmonary resuscitation                                                           
  endotracheal or esophageal obturator airway intubation
  administration of intravenous fluids and/or administration of intramuscular, intratracheal or subcutaneous drugs 
  electrical conversion of arrhythmia.                                                                                    Keep in mind that Medicare assigns no relative value units to this code, and few other payers reimburse for this service.