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Emergency Department Facility Level Coding Guidelines

Illinois Medicaid - HFS·IL · Emergency Medicine·Provider Notice
Effective date
Dec 1, 2010
We identified it
Jun 20, 2026
Days to comply

Summary

Emergency Department claims must now include specific HCPCS codes paired with appropriate revenue codes. Revenue codes 0450, 0456, and 0451 each require designated CPT/HCPCS codes to be billed together for proper reimbursement.

Action Required

Action needed
Immediately: Billing team must update Emergency Department billing procedures to ensure proper code pairing. Revenue Code 0450 must be billed with CPT 99284, 99285, 99291 or HCPCS G0383, G0384. Revenue Code 0456 must be billed with CPT 99282, 99283 or HCPCS G0381, G0382. Revenue Code 0451 must be billed with CPT 99281 or HCPCS G0380. Update billing system edits to require these code combinations. Claims missing required CPT/HCPCS codes with ER revenue codes will not be appropriately reimbursed.

Affected Billing Codes

99284
99285
99291
G0383
G0384
99282
99283
G0381
G0382
99281
G0380