Practice Management Alert

Learn when to report critical care codes multiple times

Before billing critical care services, you need to verify that your physician or coder submitted the correct codes based on documented critical care time

In the August 2006 article -Remember These Pointers for Sound Critical Care Billing- our experts told you how to overcome critical care coding dilemmas. Knowing which critical care codes to bill for is your next step.

Best strategy: Check the physician's documented total critical care time per date of service and select the correct units of 99291 and 99292 based on this simple chart.

Duration of care                  Code(s) 

Fewer than 30 minutes           Other appropriate E/M Codes

30 minutes to 1 hour,              99291
14 minutes  

1 hour, 15 minutes to              99291, 99292
1 hour, 44 minutes

1 hour, 45 minutes to              99291, 99292 x 2 
2 hours, 14 minutes

2 hours, 15 minutes to            99291, 99292 x 3 
2 hours, 44 minutes

2 hours, 45 minutes to            99291, 99292 x 4 
3 hours, 14 minutes

3 hours, 15 minutes to           99291, 99292 x 5 
3 hours, 44 minutes

Tip: For critical care time lasting beyond the examples listed here, simply add one unit of 99292 for each additional 30 minutes in the same manner illustrated in the chart. You qualify for each additional 30 minutes after the physician has spent and documented at least 15 minutes. Also, remember to reset to 99291 after midnight of any day.