Wiki 99285 all inclusive?

[pammalou]

I am new to billing ER charges and I was instructed to not bill out a level 5=99285 because it all encompasses any IV/IM, etc charges. Is this correct? I am not finding any documentation/literature to help me with deciding facility level charges (not physician charges) and am struggling because what I am given looks like I should be able to charge out a 99285 on a couple of occasions. I have done physician billing for 12 years but this facility billing is new to me as of 3 weeks ago. Any help and guidance as to where I can find information to further educate myself would be appreciated. Thank you.

 

[mitchellde]

The facility is required to have a facility tool to use for the assessment of their E&M codes it cannot be the providers guidelines and it cannot be based on time. Also the admin of drugs is not included in the level 5 code. In fact the guidelines for setting up the facility assessment tool states that if a separate CPT code exisits for any service performed it cannot be included in the assessment of the E&M