Wiki 99291/99292

[Cyndi113]

Hi there, I need help from the collective coding brain, please.

I have an MD who saw patient in the am in PICU and spent 75 mins in care. That same day MD #2 sees the same patient and spends 35 mins with patient. (Same group/tax id)

The discussion in our group is this: Dr 1 should bill 99291 and Dr 2 should bill 99292. It will most likely need to be appealed but it should be paid. Correct?? Others feel that only one MD should bill cc.

Thanks for your help

 

[FTessaBartels]

Critical Care - 2 doctors

In our practice, if two physicians from the same specialty BOTH perform critical care service on a patient in the same DOS, then we bill the TOTAL amount of critical care to the physician who FIRST saw the patient.

We do this because in the eyes of the payor world, two physicians from the same practice and same specialty are considered ONE physician.

Our intensivists cover the ICU 24-hours a day ... obviously with more than one shift. Over the course of a year, it all averages out.

Hope that helps.

F Tessa Bartels, CPC, CEMC