Neurology & Pain Management Coding Alert

Avoid costly denials by knowing what's included with 99291. Your neurologist could be involved in critical care treatment at any time. Just as she needs to be prepared for such an event, you also need to know the rules of reporting critical care, or you risk seeing the denials pour in. By following three expert tips, you'll ensure that you're not overusing -- or under-using -- the critical care codes. 1. Satisfy 3 Criteria Before Choosing Critical Care Before you consider reporting 99291 (Critical care,evaluation and management of the critically ill or critically injured patient; first 30-74 minutes) or +99292 (... each additional 30 minutes [List separately in addition to code for primary procedure]), you need to ensure your neurologist's service meets three criteria. First, the patient must meet the definition of critically ill or critically injured. A critical illness or injury is defined by a high probability of imminent or life-threatening [...]