Wiki Threshold time for 99292

[dreamer662]

Hi,
I would like to know if there is a threshold time for CPT critical care code 99292. For example how do we code 85 minutes of critical care time.
99291 for the first 74 minutes and for the remaining 11 minutes do we use 99292 , I am not able to find substantial evidence that there is a 15 minutes threshold time for 99292. Please let me know..

Thank you!

 

[ENTcoderConnecticut]

Reply

Look at page 24 of the CPT book. Also be sure of the age of the patient, has to be 72 months of age or older, 6 years. It also states that work related to the care of the patient, falls under the time count.

 

[RebeccaCross*]

Read 30.6.12 Page 65 for CC guidelines

If you scroll further down, it will give you the breakdown for increments. Pages 71-72

https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/clm104c12.pdf

 

[dreamer662]

Thankyou very much!

Thank you very much for Glennbreda and Rebeccacross for replying and providing a very informative document. I understand that critical care codes are time based codes and every minute that the physician provides critical care is counted. Thereby there is no such thing as threshold time...

Thank you

 

[MCHUBB]

99292 and Threshold times

I have looked everywhere in the articles provided in this thread and other regarding this and a specific time that we have to get to... I can find nothing to support this, not in the CPT book, the CMS manual and of the MLN NOTHING. If anyone can give me an exact quote and an exact place to find this, I would be happy to concede but so far.... any over 74 minutes.... constitutes 99292 with no time limit.

Any help is appreciated.