Pulmonology Coding Alert

Question: Which code should we report if the physician sees a critically ill patient for less than 30 minutes? Our pulmon­ologist worked with a critically ill COPD patient, and even after tallying floor time and discussions with other practi­tioners, we only get to 20 minutes.

Minnesota Subscriber

Answer: A service lasting fewer than 30 minutes does not meet the critical care guidelines, since even the lowest level of critical care (99291, Critical care, evaluation and management of the critically ill or critically injured patient; first 30-74 minutes) requires you to at least meet the 30-minute time threshold.

Therefore, you should report another appropriate E/M code depending on the services rendered. For instance, if your documentation reflects a level-two subsequent hospital care visit, you’ll report 99232 (Subsequent hospital care, per day, for the evaluation and management of a patient, which requires at least 2 of these 3 key components…).