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Thread: Critical Care Question

  1. #1

    Default Critical Care Question

    AAPC: Back to School
    Hi all,
    In the hospital setting, we have a pt. (53 yrs old) who was in the ICU/Critical Care Services and was transfered directly to another hospital. For CPT purposes, would this be a regular discharge (ex: 99238) or would you use the critical care codes (ex:99291-99292). A fellow coder suggested using the critical care code as the pt. was being treated until the transfer, but at the same time, the pt. is being discharged from the hospital

    I'd appreciate your advice on this and if possible, provide a link to this guideline.

    Thank you very much,

  2. #2


    I suppose this must be a difficult scenario....(many read, but no reply)....

  3. #3
    Join Date
    Apr 2007
    Milwaukee WI

    Default Depends on documentation

    Assuming you are coding for the PHYSICIAN and not the hospital ... If critical care was documented I would code the critical care.

    F Tessa Bartels, CPC, CEMC

  4. #4


    Thanks Tessa for the reply.

    Unfortunately, I couldn't find any official coding guidelines for this.....
    (Like you said, I suppose we'll have to go with the only reliable method....... documentation!!!).

  5. #5


    Assuming you are billing for the physician:

    To use the critical care codes the Dr MUST document the time spent with the patient. It has to be at least over 30 minutes to use the critcal care code. Like I said, the Dr MUST have in their documentation that they spent OVER 30 MINUTES with the patient. That means they spent the time with the patient, not the nurses, not the staff, the actual physician.
    If there is no time documented you need to stick with your discharge codes.

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