Wiki Same Group Critical Care different locations

[larcwing]

Hi There. I code for a group of Critical care physicians that float around various area hospitals and LTACs. Now I understand that a group of physicians bill critical care as one provider. My question is how would you bill critical care (assuming time and documentation requirements were met) for a patient that is seen at Facility A seen by Dr. A and transferred to Facility B and Seen by Dr. B on the same day. Dr. A and B are both part of the same group practice. Would Dr. A get 99291 and Dr. B get 99292, or would they both get 99291 because of the different facilities? I lean toward the A - 99291, B - 99292 because it states per day, but I have an MD who argues for the later option.

 

[Porter_kd]

Per Medicare Claims Processing Manual chapter 12-The CPT code 99291 is used to report the first 30-74 minutes of critical care on a given calendar date of service. It should only be used once per calendar date per patient by the same physician or physician group of the same specialty. So only report 99291 once, then 99292 based on how much time was spent by Dr. B.