The documentation for each visit must stand alone. Nothing used in documenting the 99285 (nor the time required for performing/documenting) can be used in documenting 99291. And vice versa.
Personally I would just code the 99291 if the requirements for that service were met and documented. Reimbursement is usually better for this code than for even the highest level of ER services.
NOTE that time spent in performing procedures (e.g. intubation, thoracentesis) can NOT be counted in the critical care time. These procedures should be separately reported.
Hope that helps.
F Tessa Bartels, CPC, CEMC
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