Wiki Two dumb questions! Trauma Bay and 9928X

[bill2doc]

So I am billing professional services for a trauma doc. He gave me paperwork that shows Critical Care time 1:06 which I know is 99291. Should I also be billing for a 9928x along with the trauma code 99291 ?? Also, the Doc says he sees the Patient in the "Trauma Bay", face sheet lists "Emergency Trauma" not sure if my POS is 21 or 23.

Thank you in advance
Lynn

 

[jimbo1231]

Don't think so.

Also if your are billing for Critical Care, you would not also bill for a 99281-5 for the same encounter.

Jim

 

[bill2doc]

Thank you, can you tell if a patient is presented in the Trauma Bay and called in as Trauma, can I bill a 99291 for say concussion or do I need to change the CPT code to something different??? So confused...Keep in mind, patient place of service is 23 at this point.

 

[ajs]

Thank you, can you tell if a patient is presented in the Trauma Bay and called in as Trauma, can I bill a 99291 for say concussion or do I need to change the CPT code to something different??? So confused...Keep in mind, patient place of service is 23 at this point.

I would carefully read the section describing Critcal Care Services in the CPT book that precedes the critial care E/M codes. Critical care is intended to indicate that the patient is need an extremely high level of care due to the extent of their medical condition. Generally there is single or multiple organ failure involved. A concussion could qualify depending on the severity of the injury and if the patient is in a life threatening situation. Just because a patient is in a Trauma area in the ER does not automatically quality for Critical Care.