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Question CPT 99291 and 99292

ror2029

New
Messages
4
Location
Staten Island, NY
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0
When Billing CPT 99291 and 99292 are we supposed to add the Providers time or the first provider must go over 74 minutes the the second provider billed CPT 99292.
 

kayleeevans907

Networker
Messages
38
Location
Fairbanks, Alaska
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0
When I review the code description in Encoder Pro it says this " Code 99291 represents the first 30 to 74 minutes of critical care and is reported once per day. Additional time beyond the first 74 minutes is reported in 30 minute increments with 99292. "
I read this as the first provider that renders critical care charges 99291 and from then on if anyone else provides critical care they can only charge 99292 since 99291 can only be reported once per day.
 

ror2029

New
Messages
4
Location
Staten Island, NY
Best answers
0
When I review the code description in Encoder Pro it says this " Code 99291 represents the first 30 to 74 minutes of critical care and is reported once per day. Additional time beyond the first 74 minutes is reported in 30 minute increments with 99292. "
I read this as the first provider that renders critical care charges 99291 and from then on if anyone else provides critical care they can only charge 99292 since 99291 can only be reported once per day.
Thank you
 

SharonCollachi

True Blue
Messages
1,227
Location
Clovis, CA
Best answers
3
The new rules about those two codes say that the 2nd provider in the same group is now allowed to bill 99292, instead of adding all the time to the first provider and billing it under the first provider.

If the total time added together for both is not more than 74 minutes, then I do not believe you should be billing both 99291 for first provider and 99292 for 2nd provider. Under the old rules, that would still be 99291 for one provider.
 

ror2029

New
Messages
4
Location
Staten Island, NY
Best answers
0
The new rules about those two codes say that the 2nd provider in the same group is now allowed to bill 99292, instead of adding all the time to the first provider and billing it under the first provider.

If the total time added together for both is not more than 74 minutes, then I do not believe you should be billing both 99291 for first provider and 99292 for 2nd provider. Under the old rules, that would still be 99291 for one provider.
So if a provider spends 140 Total Minutes he should bill CPT 99291 once and then CPT 99292 (x3) right? According to this...
135-164 minutes (2 hr. 15 min. - 2 hr. 44 min.) 99291 X 1 AND 99292 X 3
 

kayleeevans907

Networker
Messages
38
Location
Fairbanks, Alaska
Best answers
0
for 140 minutes I would be charging the following:
99291 (74 minutes)
99292 x2 (additional 66 minutes)
The additional 66 minutes can be broken up into two charges for the additional 30 minutes that 99292 requires, I wouldn't charge a 3rd unit for 6 minutes.
 
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