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2025 CPT code 99288

Physician direction of emergency medical systems (EMS) emergency care, advanced life support.

This code should not be reported if there is a face-to-face encounter with the patient or if the patient doesn't arrive at the ED where the provider works.Consider other codes (e.g., 99466, 99467, 99485, 99486) for interfacility transport scenarios depending on specific criteria.

Modifiers may be applicable depending on the specific circumstances of the service provided.Consult the CPT manual and payer guidelines for appropriate modifier use.

Medical necessity is established when the patient is unstable and requires advanced life support interventions before arriving at the ED.The physician's direction is crucial for timely and appropriate treatment, potentially improving patient outcomes.The patient should require advanced cardiac or trauma life support during the transport.

The physician or qualified healthcare professional is responsible for providing real-time medical direction to EMS personnel managing a critically ill or injured patient en route to or from the emergency department. This includes directing procedures and treatment based on the patient's condition.

IMPORTANT:Use 99466 and 99467 for interfacility transport of critically ill children under 2 requiring face-to-face care.Use 99485 and 99486 for supervision of interfacility transport without face-to-face care.

In simple words: This code covers a doctor's instructions given to emergency medical services (EMS) personnel over the radio, while they are treating a seriously ill or injured patient before they reach the hospital. The instructions might include things like starting IV fluids, performing CPR, or using a defibrillator.

This CPT code reports the supervision of care by an emergency or control provider to EMS staff outside the facility for an unstable patient requiring advanced cardiac or trauma life support.The provider gives medical direction via two-way communication, directing medically necessary procedures such as cardiac rhythm telemetry, CPR, endotracheal or esophageal intubation, IV fluid/drug administration, defibrillation, or cardioversion.

Example 1: An EMS crew is transporting a patient experiencing cardiac arrest. The ED physician uses two-way radio communication to guide the crew on administering CPR, administering medications, and performing defibrillation., A trauma patient is being transported after a motor vehicle accident. The trauma surgeon provides real-time instructions to the EMS crew regarding fluid resuscitation, airway management, and other interventions based on continuous updates on the patient's condition., A patient with a severe allergic reaction is being transported to the ED. An allergist directs the EMS crew on administering epinephrine, using an airway adjunct, and monitoring vital signs.

Detailed documentation is needed to support the medical necessity of this code, including specifics of the patient’s condition, interventions directed by the physician, and the time spent providing direction.Documentation should include the time the communication began and ended. The documentation should describe the patient's condition and the medical interventions that were dictated over the two-way radio communication.

** This code is often not reimbursed by insurance companies.Always check payer-specific policies and guidelines before reporting this code.

** Only Enterprise users with EHR integration can access case-specific answers. Click here to request access.

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