ED Coding and Reimbursement Alert

Test your coding knowledge.  Determine how you would code this situation before looking at the box below for the answer.
Question: If one ED physician admits a patient to observation care and another ED physician provides critical care to that patient while he or she is in observation care, can the doctor providing the critical care bill for this service?

Oklahoma Subscriber

Answer: The ED physician who provides critical care can bill for the services, but it is important to ensure that such services are actually provided. CPT 2001 revised its terminology to help clarify the issue and make it easier to determine what is considered critical care.
 
Codes 99291 (critical care, evaluation and management of the critically ill or critically injured patient; first 30-74 minutes) and 99292 (... each additional 30 minutes) are time-based codes, and as such, the amount of time (devoted solely to that patient) the physician spends in critical care needs to be documented in the patient's medical record. For more information, see the article "Avoid Undercoding: Choose Critical Care Instead of 99285" in the June 2001 issue of ED Coding Alert.