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ED Coding and Reimbursement Alert

READER QUESTIONS:

Secure Proper Documentation for 99288

Published on Mon Aug 23, 2004

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.

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