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Critical Care vs. ER High Complexity

  1. Default Critical Care vs. ER High Complexity
    Medical Coding Books
    I have a doctor who is wondering how to charge out a patient who came through the ER and part of her visit was critical care. She says if the patient is only critical care for 1 1/2 hours and the other couple hours were not, which code would we use? It is my understanding we cannot use 99285 and 99291 so which way would we go? Any help will be greatly appreciated.

  2. Default
    You would code the 90 minutes of CC. The Dr has to clearly document that 90 minutes was engaged fully on that patient alone. 90 minutes would be coded as 99291 99292.

  3. Default
    Thanks for the quick response. How would you code the rest of the visit then if you can't use the 99285?

  4. Default
    the rest of the visit would be included with the charge for the CC. You would not be able to code for it seperately.

    Connie Wilson CPC, CEDC

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