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Threshold time for 99292

  1. #1
    Default Threshold time for 99292
    Medical Coding Books
    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!

  2. Default 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.

  3. #3
    Location
    North Carolina
    Posts
    80
    Default 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-.../clm104c12.pdf

  4. #4
    Default 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

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