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First day consultation and subsequent critical care

  1. Default First day consultation and subsequent critical care
    Medical Coding Books
    If I use code 99255 for first day inpatient consultation for my neurologist doctor, can I use 99291 for subsequent visits?

    thank you in advance..

  2. Default
    Critical care codes can be given.
    Proper documentation of time is required to assign the appropriate code.
    Critical care coding is separate and may not be combined with any other procedure on the same day.

  3. #3
    Milwaukee WI
    Default Guidelines for critical care
    Is the neurologist truly providing critical care to a critically ill patient? Per CPT 2009 Professional edition (pg 18) ... "Critical care involves high comolexcity decisio making to assess, manipulate, and support vital system function(s) to treat single or multiple vital organ system failure and/or to prevent further life threatening deterioration of the patient's condition."

    So if the care provided meets that criterion and the patient is also critically ill, then yes, your neurologist can use the 99291-99292 code(s). If that is the level of care provided on day one I'd code 99291 for that date instead of the consult.

    F Tessa Bartels, CPC, CEMC

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