Wiki ED critical care

[awalker2@ecommunity.com]

If a patient presents to the ED and has critical care services 99291.. Does the facility charge the 99291 in addition to the initial ED charge as well as the ED Physician? or Are the 99291 and 99292 only for Physician?

 

[thomas7331]

For the facility, the 99291 (and 99292, if billed) would replace the ED charge, not be billed in addition to it, if this is for a single encounter. Typically, the facility will bill the critical care code if the physician has documented it, but your organization should give you guidance on this since facility charges are generally based on resource utilization and not on physician E&M work, and the internal guidelines on this may vary from place to place.