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Critical care coding

Nancy Grisanti

Contributor
Messages
16
Location
Watertown New York
Best answers
0
I have a question regarding whether a PA and an MD both working for the same employer/facility can combine their time together? We had a PA administer 14 minutes of critical care in the ER and then the MD arrived and administered 16 minutes of critical care. Can we add both times together to use 99291? If not, could you please give me a reference source for this info?
 

RebeccaWoodward*

True Blue
Messages
3,126
Location
North Carolina
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0
Split/Shared Service

A split/shared E/M service performed by a physician and a qualified NPP of the same group practice (or employed by the same employer) cannot be reported as a critical care service. Critical care services are reflective of the care and management of a critically ill or critically injured patient by an individual physician or qualified non-physician practitioner for the specified reportable period of time.

Unlike other E/M services where a split/shared service is allowed the critical care service reported shall reflect the evaluation, treatment and management of a patient by an individual physician or qualified non-physician practitioner and shall not be representative of a combined service between a physician and a qualified NPP.

When CPT code time requirements for both 99291 and 99292 and critical care criteria are met for a medically necessary visit by a qualified NPP the service shall be billed using the appropriate individual NPI number. Medically necessary visit(s) that do not meet these requirements shall be reported as subsequent hospital care services.

30.6.12 E

http://www.cms.hhs.gov/manuals/downloads/clm104c12.pdf
 
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