Part B Insider (Multispecialty) Coding Alert
Know the Settings Where Critical Care Can Be Reported
PDF
Question: Our physicians often perform critical care (99291-+99292) when they do rounds in the intensive care unit, but we are curious about whether we can bill these codes for services performed in a standard hospital room or in the office. Is that something we can bill with 99291? Maryland Subscriber Answer: Yes, you can report 99291 (Critical care, evaluation and management of the critically ill or critically injured patient; first 30-74 minutes) in the outpatient setting, as long as you meet the requirements of the code. The provider must be directly delivering medical care for a critically ill or critically injured patient and must meet the time thresholds to bill the code. For example, suppose a patient is doing a six-minute walk test in your hallway and goes into cardiac arrest. The physician administers critical care services for 30 minutes until the EMTs place her in an ambulance to take her to the hospital. In this situation, you can report 99291, assuming that the documentation supports the code.
Related Articles
Part B Insider (Multispecialty) Coding Alert
- Medicare Provider Enrollment:
Feds Delay Affiliation Directives on Provider Apps
Don’t anticipate the updated CMS-855 application until 2022 — or later. If sending Medicare the [...] - Mythbusters:
Debunk 5 QPP Myths With These Facts
See which providers can receive MIPS special status. COVID-19 may have wreaked havoc on your [...] - Documentation:
Perfect Part B Documentation With These Pointers
Tip: Know the Medicare rules on medical record amendments. One of the most important factors [...] - Part B Coding Coach:
Tackle GI Imaging Services Coding With These Top Tips
Hint: Examine the specific area visualized before selecting a code. Most providers who perform upper [...] - Reader Question:
Know the Settings Where Critical Care Can Be Reported
Question: Our physicians often perform critical care (99291-+99292) when they do rounds in the intensive [...] - Physician Notes:
HHS Renewed the PHE for a 5th Time
On April 15, HHS Secretary Xavier Becerra extended the COVID-19 public health emergency (PHE) and [...] - Physician Notes:
CMS Extends 2% Sequestration Suspension Until End of 2021
You have a little more time before you need to worry about the 2 percent [...] - Physician Notes:
See Details on HHS’ Latest Round of Provider Relief Guidance Revisions
If you’re planning on doing your Provider Relief Fund (PRF) reporting soon, you may want [...]