Gastroenterology Coding Alert

Do your physicians know what's bundled into 99291? Your gastroenterologist reports to a local emergency department (ED) and provides a patient with 42 minutes of critical care; you don't recognize the patient as critically injured, so you report a level-five ED E/M instead. No big deal ... right? Wrong: The critical care code pays around $45 more per claim. This FAQ will help you snare all the cash you can on each potential critical care claim. What's Critical Care? "When the nurse turns to you and says, 'We need you in room 4 NOW,' there's a pretty good chance you are about to see a critically ill patient who needs some type of intervention to prevent further deterioration in their condition," explains Michael Lemanski, MD, billing director at Baystate Medical Center in Springfield, Mass. For coding purposes a patient must be critically ill or injured in order to receive critical [...]