Wiki Critical Care VS Consult

[Abayevster@gmail.com]

Hi All,

One of my Dr's asked me today if he is allowed to bill for critical care if he is doing a consult on a critically ill patient.
We are facility based but I code for the providers. When patients are in the general medical floor, my Dr's go and evaluate them before decided if they qualify for the ICU.
Sometimes the decide that they shouldn't be brought to the ICU. Sometimes they are monitored for a few days before a decision is made.
So they want to know if they can charge for 99291 instead of a consult code for seeing the patient in the general medicine area. Or is 99291 only to be used in the ICU?

 

[Tami_F]

Hi All,

One of my Dr's asked me today if he is allowed to bill for critical care if he is doing a consult on a critically ill patient.
We are facility based but I code for the providers. When patients are in the general medical floor, my Dr's go and evaluate them before decided if they qualify for the ICU.
Sometimes the decide that they shouldn't be brought to the ICU. Sometimes they are monitored for a few days before a decision is made.
So they want to know if they can charge for 99291 instead of a consult code for seeing the patient in the general medicine area. Or is 99291 only to be used in the ICU?

Yes. If he provides critical care to a patient he is consulting on, he should document it appropriately, and it will be billable. If he does not provide critical care, a consult should be billed.

Critical care can be provided in any setting, it is not dependent on the physical location of the patient.

 

[Abayevster@gmail.com]

Yes. If he provides critical care to a patient he is consulting on, he should document it appropriately, and it will be billable. If he does not provide critical care, a consult should be billed.

Critical care can be provided in any setting, it is not dependent on the physical location of the patient.

Thanks for the feedback, I appreciate it.