ACEP Emergency Department Facility Coding – Level 1 (CPT 99281)

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

  • CPT Code: 99281

  • Type A: APC 609

  • Type B: APC 626

  • HCPCS: G0380




Possible Interventions for Level 1 (CPT 99281)

Typical interventions for Level 1 ED visits may include:

  • Initial patient assessment

  • No medications or treatments administered

  • Prescription refill only (asymptomatic)

  • Providing a work or school note

  • Wound recheck with no complications

  • Booster or follow-up immunization (no acute injury)

  • Uncomplicated dressing changes

  • Simple suture removal

  • Straightforward discharge instructions

  • Reading a TB test

  • Minor insect bite care (uncomplicated)


Common Symptoms or Examples Supporting Level 1

  • No acute distress or urgent medical need

  • Follow-up visit without new symptoms

  • Administrative-only encounters (e.g., work note)

  • Mild skin issues without infection or swelling

  • Immunization or TB test result reading

  • Simple wound care without further procedures


Coding & Documentation Tips for CPT 99281

  • Document all services provided, even if minimal

  • Clearly state no diagnostic testing or treatment beyond basic care

  • Use precise wording in the chart to support a Level 1 code

  • 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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