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.
- ICD-10 Trainings
- Comprehensive Courses
- CPC (Certified Professional Coder)
- COC (Certified Outpatient Coder)
- CIC (Certified Inpatient Coder) NEW!
- CRC (Certified Risk Adjustment Coder) NEW!
- CPB (Certified Professional Biller)
- CPMA (Certified Professional Medical Auditor)
- CDEO (Certified Documentation Expert – Outpatient) NEW!
- CPPM (Certified Physician Practice Manager)
- CPCO (Certified Professional Compliance Officer)
- VIEW ALL CERTIFICATIONS
Coding / Billing Solutions
- Audit / Compliance Solutions
Job Experience / Apprentice Removal
News / Discussion
- Other Resources
- Book Store
- Log In / Join