Introduction to Level 1 ED Facility Coding
In emergency department (ED) facility coding, Level 1 represents the lowest level of complexity and resource usage. According to ACEP ED Facility Guidelines, Level 1 visits require minimal interventions and are usually for non-urgent concerns or follow-up care.
Correctly assigning CPT 99281 ensures accurate billing and compliance with Medicare and commercial insurance requirements.
Level 1 Facility Charge Assignment Details
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CPT Code: 99281
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Type A: APC 609
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Type B: APC 626
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HCPCS: G0380
Possible Interventions for Level 1 (CPT 99281)
Typical interventions for Level 1 ED visits may include:
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Initial patient assessment
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No medications or treatments administered
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Prescription refill only (asymptomatic)
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Providing a work or school note
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Wound recheck with no complications
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Booster or follow-up immunization (no acute injury)
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Uncomplicated dressing changes
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Simple suture removal
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Straightforward discharge instructions
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Reading a TB test
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Minor insect bite care (uncomplicated)
Common Symptoms or Examples Supporting Level 1
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No acute distress or urgent medical need
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Follow-up visit without new symptoms
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Administrative-only encounters (e.g., work note)
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Mild skin issues without infection or swelling
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Immunization or TB test result reading
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Simple wound care without further procedures
Coding & Documentation Tips for CPT 99281
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Document all services provided, even if minimal
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Clearly state no diagnostic testing or treatment beyond basic care
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Use precise wording in the chart to support a Level 1 code
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If any diagnostic tests or additional procedures are performed, the case may qualify for Level 2 (CPT 99282)
✅ Summary: Level 1 ED facility coding is designed for non-urgent, minimal resource use visits. Correct use of CPT 99281 ensures compliance, proper reimbursement, and accurate reporting.
Next in the series: ACEP ED Facility Level 2 – Low Resource Use.
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