You Be the Coder:
Cardiac Arrest
Published on Mon Apr 01, 2002
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Test your coding knowledge. Determine how you would code this situation before looking at the box below for the answer.
Question: Our internist was at the hospital today seeing one of our patients when he responded to a "stat" call for a cardiac arrest. This patient is not his, and the arrest patient's original physician wants to bill his inpatient code for that day. How does my doctor get reimbursed for responding to the stat call?
Washington Subscriber
Answer: Code 92950 (Cardiopulmonary resuscitation [e.g., in cardiac arrest]) describes the specific service your physician performed and will not interfere in any way with the bill submitted by the patient's regular physician.
Ask your physician if he or she spent any time after the resuscitation attending to the patient, because the patient's condition meets the CPT definition of a critically ill patient (impairment of one or more vital organ systems such that there is a high probability of imminent or life-threatening deterioration in the patient's condition). Critical care codes are time-based, so your physician must have spent at least 30 minutes of noncontinuous time providing care to the patient to bill 99291 (Critical care, evaluation and management of the critically ill or critically injured patient; first 30-74 minutes).
The care does not need to be at the bedside and may include the following activities as long as they were provided on the patient's floor or unit: reviewing test results or imaging studies, discussing the critically ill patient's care with other medical staff, or documenting critical care services in the medical record. Time spent performing any of the above activities is counted in add-ition to any time spent providing bedside care to the patient.
Be careful, however, that you do not include the time spent resuscitating the patient in your critical care calculations. Code 92950 is not bundled into critical care and is separately billable, so any time spent providing a separately billable service is not counted as critical care time. As with all time-based codes, the physician must document the time spent in the medical record to bill this code. If your physician's post-resuscitation critical care time exceeds 74 minutes, you may also bill +99292 (Critical care, evaluation and management of the critically ill or critically injured patient; each additional 30 minutes) in addition to 99291. You should use 427.5 (Cardiac arrest) for your diagnosis for this encounter.
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