standard times for procedures with CCT?

deborahcook4040

Networker
Messages
97
Location
Ocala, FL
Best answers
0
My provider "read somewhere" that Medicare is allowing subtraction of standardized times for separately billable procedures with Critical Care Time instead of exact time reporting. For example, he documented "120 minutes of CCT including time spent inserting Central Line" and he wants me to find the average time spent inserting a central line, subtract it from his total, and bill out that amount of CCT.

I can't find anything written to support this policy - has anyone else heard something like this? And have you seen anything in writing?
 

jsalzer50

Networker
Messages
67
Location
Vancouver, WA
Best answers
0
Critical Care Codes

Hey Deborah,

Yes, I have heard of this before in my coding classes in college.

And yes, I have read about this too, both online and in my CPT code book:

On page 24 in the CPT 2016 Professional: "Time spent in activities that occur outside of the unit or off the floor (eg, telephone calls whether taken at home, in the office, or elsewhere in the hospital) may not be reported as critical care since the individual is not immediately available to the patient.... Time spent performing separately reportable procedures or services should not be included in the time reported as critical care time." (page. 24, CPT Professional 2016)

Here is a link about this from ACEP: https://www.acep.org/Physician-Reso...ial-Issues-/-Reimbursement/Critical-Care-FAQ/

I also just found an example of an ED visit where 3 minutes was spent inserting a central line, while another one took 5 minutes. So....with 120 minutes total, and subtracting 5 minutes, even up to 15 minutes, we are still within the range of 105-134 minutes (1 hr. 15 min, to 1 hr. 44 min.) giving us codes: 99291, 99292, 99292.

Sincerely,
Jacob
 
Top