Wiki Hospital visit and ICU add on code

[encomma-watson]

I work for an Internal Medicine doctor who also goes to the hospital to visit patient's. One of his patient's was seen while in ICU. I know that we can use 99232 and 99292 but is there an modifier used while billing these two codes?

 

[kathyshelton]

critical care and hospital visits

as I'm sure you probably are aware....just because they are in ICU doesn't always mean an automatic critical care code.

 

[FTessaBartels]

99292 NOT added to 99232

You would use 99292 ONLY if you had 75 or more minutes of face-to-face critical care, and it would be an add-on to 99291 (covering face-to-face critical care time of 30-74 minutes).

Please look at the guidelines for Critical Care in your 2009 CPT Professional Edition, beginning on page 18. I know they are long but it's really important to read and understand all of it.

As Kathy Shelton stated, just because the patient is in the ICU does not mean that the care provided is critical care. It is possible that the hospital intensivist provided the critical care and the patient's doctor (your internal medicine MD) only provided a 99232.

Hope that helps.

F Tessa Bartels, CPC, CEMC