Wiki TC Component of ED Visits

[jboes41527]

I've got a question regarding the PC/TC billing for ED Visits. Our Professional (PC) portion of the ED visits is outsourced, so our hospital is only reporting for the Technical side (TC). Recently I've seen a spike in the use of Critical Care (99291) and I'm now also beginning to see denials stating that 99291 is for the professional component only. Any suggestions? Our codeers follow the ACEP guidlines, but I'm wondering if they are not meant for professional coding only?
Are there guidelines for the facility side? Any help is appreciated -Thank you

 

[LTibbetts]

Check out the post in this forum. I believe it is under "Facility ER E/M coding". It has a lot of info that might be useful to answer your question.

 

[maudys]

we also code for critical care in our ER, and we do not receive denials for facility use. you just have to follow the same guidelines for critical care as a physician would, i.e., time and definition of critical care. does your facility have an E/M policy? CMS recommends that each facility develop a policy for this and follow it.