Advanced Search

ED Coding and Reimbursement Alert

READER QUESTIONS :

Proper Dx Code Secures Post-Op 99291 Claim

Published on Fri Jun 12, 2009

Question: A patient who had heart surgery Monday is in the hospitals intensive care unit. The unit calls the ED physician Tuesday morning, when the patient suffers acute respiratory failure. The physician provides 66 minutes of critical care for the patient. How do we code for this, being that the ED physician did not perform the initial surgery? Massachusetts Subscriber Answer: Youll be able to report the critical care even though it occurs in the global period of another procedure -- just make sure to append the proper modifier to the code, and to include a diagnosis code that specifies what illness your physician is treating. On the claim, report 99291 (Critical care, evaluation and management of the critically ill or critically injured patient; first 30-74 minutes) for the physicians service with 518.81 (Acute respiratory failure) appended. The 518.81 code is vital to this claim, as it shows that the ED [...]
You’ve reached your limit of free articles. Already a subscriber? Log in.
Not a subscriber? Subscribe today to continue reading this article. Plus, you’ll get:
  • Simple explanations of current healthcare regulations and payer programs
  • Real-world reporting scenarios solved by our expert coders
  • Industry news, such as MAC and RAC activities, the OIG Work Plan, and CERT reports
  • Instant access to every article ever published in your eNewsletter
  • 6 annual AAPC-approved CEUs*
  • The latest updates for CPT®, ICD-10-CM, HCPCS Level II, NCCI edits, modifiers, compliance, technology, practice management, and more
*CEUs available with select eNewsletters.

Other Articles in this issue of

ED Coding and Reimbursement Alert

View All