Critical care

LEE ANN

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How much critical care time would you bill in this situation.

Provider initiates care 02:30 he signs his note at 03:43. Never says critical care time spent anywhere in his note. Patient was seen in the PICU - which I know doesn't necessarily mean critical care. He does an addendum starting @ 05:00 and states "additional 45 minutes of critical care time spent". From the time documented on the first note would you bill the 1hr and 13 minutes of critical care time or just the 45 that he specifically says was critical care time spent in the 2nd note.

If you would bill the first 1:13 - what are you documentation guideline are you using to support your decision?

My opinion is - I would bill 99223 (supported by documentation) for the initial visit because the provider doesn't say critical care time. I would then bill 99291 for the 45 minutes that are specified as critical care.
 
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