CPT states "Critical care and other E/M services may be provided to the same pt on the same day by the same physician." CCI doesn't show any edits for the initial inpt codes with 99291 so you shouldn't need a modifier. The documentation must have total minutes of critical care time (at least 30 min) in order to bill 99291. You may need to appeal with the note. If your dr's note doesn't specifically record the critical care time with pt, you cannot bill 99291.
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