Wiki E/M coding for physician inpatient charges

[imcbmcc]

At our practice we have both pulmonologists and intensivists. Differently specialty but same group. When each of the providers sees same patient, inpatient, on same day are we able to bill out 99471/99472 or 99475/99476 for each provider? These patients are being seen in the pediatric intensive care unit.

Thank you so much for any clarification you can provide.

 

[Tami_F]

At our practice we have both pulmonologists and intensivists. Differently specialty but same group. When each of the providers sees same patient, inpatient, on same day are we able to bill out 99471/99472 or 99475/99476 for each provider? These patients are being seen in the pediatric intensive care unit.

In short: no.
1. The location of the patient at the time of service does not determine the level of care. Just because a patient is in the PICU does not mean that it is appropriate to bill critical care.
2. The pediatric critical care codes should only be billed by the attending provider/service. These are global/24 hour codes.

If your providers are a consulting service and document that they provide critical care to pediatric patients, they must document their time the same way they would for adult patients. Consulting services bill time-based critical care codes 99291-2.