Question

Using the CPT manual, determine which of the following codes would generally require the facilities available in a hospital setting?

1) Code 99213
2) Code 99201
3) Code 99281
4) Code 99245

Answer 1

Code 99281 from the CPT codes generally requires a hospital setting as it is designated for Emergency Department services. Codes 99213 and 99201 typically occur in a doctor's office or clinic, and Code 99245 is outdated. ICD codes are used across various platforms including medical laboratories and healthcare management systems.

Step-by-step explanation:

From the provided CPT codes, Code 99281 generally requires the facilities available in a hospital setting. Code 99281 is an Emergency Department visit code signifying basic emergency department services, which typically take place in a hospital environment. On the other hand, Codes 99213 and 99201 are for office or other outpatient visits for the evaluation and management of an established patient and a new patient, respectively, which are usually performed in a doctor’s office or clinic. Code 99245 is an outdated CPT code and previously represented a high level of office consultation, which again would not normally require hospital facilities.

ICD codes, such as the ones used to identify and process treatments for viral infections, are commonly found in medical laboratories and on healthcare management system records. Medical coders use ICD codes to assign the proper code for procedures performed, which proves essential for medical billers to process claims for reimbursement by insurance companies. Additionally, ICD codes are used by vital-records keepers and epidemiologists for recording mortality data and calculating morbidity and mortality statistics, respectively.