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Thread: ER Trauma ER Emergency NEW NEED HELP

  1. #1

    Default ER Trauma ER Emergency NEW NEED HELP

    AAPC: Back to School
    Hello All,

    I currently bill for a doctor who does critical care 99291 and 99292. I am going to be taking on a physician that bills for ER and ER Trauma. Emergency and Acute.

    Can someone tell me if this is similar at all to critical care billing? All of my CC billing is inpatient 21 and I'm worried that there will be little changes like the POS that I don't know about.

    Any help would be greatly appreciated

    Thank you

  2. #2


    Critical Care billing,, i.e. 99291 and 99292, should be code driven based on providers of service fulfilling the criteria of the codes and not based on a doctor's specialty. A doctor can be a "critical care doctor" but not necessarily provide services that are considered critical care. Please read and then read again the definition of 99291 and 99292 in CPT and ensure your physician has done the same. This will ensure documentation and criteria are always met when billing these time based codes. Patient status must be well documented along with total critical care time provided for each date of service. Place of service, whether in the ED (pos 23) or Inpatient (pos 21) does not drive use of critical care, however providing critical care services to a patient who is not admitted (pos 23) or is admitted and discharged in the same day should be looked at closely. Also, critical care services must be provided for a minimum of at least 30 minutes; if trauma patient arrives and then expires under 30 minutes then you cannot bill critical care.
    I hope this is helpful.

  3. #3


    The above answer should help you when coding CC.
    The E/M codes used for ED are 99281-99285. You will also use a variety of CPT codes when coding ED. You will see a variety of vistis ranging from "worried well" to critical care.

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