Results 1 to 6 of 6

Question about Critical care service question on Exam similator

  1. Default Question about Critical care service question on Exam similator
    Medical Coding Books
    I Purchased this software called Coding Certificate Exam Similator and was practicing the E/M section for the CPC exam this Saturday and I came across this one question and I think the software is wrong? I don't know, but why would the answer be based on a 24 month or older person instead of a 21 month old or pediatric? I am so confused.

    QUESTION: A 21-month-old patient is stung by a bee and goes into
    anaphylactic shock due to an allergic reaction. He is
    rushed to the emergency room, where he receives critical
    care by an emergency physician for two-and-a-half hours.
    What is the correct way to code this encounter?

    a. 99293 my answer
    b. 99295
    c. 99291,99292 x 3
    d. 99291

  2. Default
    Hi,

    I think they made a error.(21 years old male)

    Thanks
    vallikumaran,CPC

  3. #3
    Default
    Quote Originally Posted by michtitus View Post
    I Purchased this software called Coding Certificate Exam Similator and was practicing the E/M section for the CPC exam this Saturday and I came across this one question and I think the software is wrong? I don't know, but why would the answer be based on a 24 month or older person instead of a 21 month old or pediatric? I am so confused.

    QUESTION: A 21-month-old patient is stung by a bee and goes into
    anaphylactic shock due to an allergic reaction. He is
    rushed to the emergency room, where he receives critical
    care by an emergency physician for two-and-a-half hours.
    What is the correct way to code this encounter?

    a. 99293 my answer
    b. 99295
    c. 99291,99292 x 3
    d. 99291
    Hello,

    No error was made here, they are trying to trick you by saying 21 month old...

    99293 is for "Initial inpatient pediatric critical care...." According to your scenario, the patient was taken to the ER and treated by the ER doctor, nothing is stated about being admitted. ER is considered outpatient.

    99291 and 99292 are not place of service specific and may be used for inpatient and/or outpatient, and regardless of age when they are outpatient.

    If you read what 99293 - 99296 "excludes" in the CPT book ... it specifically states EXCLUDES "critical care services provided to child up to age 24 months in an outpatient area (e.g., emergency department) (99291, 99292)"

    Hope that helps!
    Last edited by ARCPC9491; 10-13-2008 at 08:18 AM.

  4. Default
    No, it's not an error. 99293 is a for initial inpatient critical care, per day. In the CPT book under inpatient neonatal and pedicatric critical care services it states for "critical care services provided in the outpatient setting( eg, emergency dept or office) for neonates and pediatric patients up through 24 mos of age, see the hourly critical care codes 99291, 99292."

  5. Default
    Seems that we must have been responding at the same time, AR!

  6. #6
    Default
    Yes, we must have!

Similar Threads

  1. yet another critical care question
    By twtcpc in forum Medical Coding General Discussion
    Replies: 0
    Last Post: 07-07-2014, 09:14 AM
  2. Critical care time question
    By jgryder@uestn.com in forum Auditing General Discussion
    Replies: 1
    Last Post: 10-22-2012, 01:38 PM
  3. Question from mt Dr re: Critical Care billing
    By melissalynnfalkowski in forum Medical Coding General Discussion
    Replies: 1
    Last Post: 09-12-2011, 03:34 PM
  4. Critical Care Question
    By rbynmnk in forum Medical Coding General Discussion
    Replies: 2
    Last Post: 04-29-2009, 03:24 PM
  5. Critical Care Question
    By meanmesh in forum Medical Coding General Discussion
    Replies: 4
    Last Post: 01-14-2009, 12:56 PM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •  
Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?

Login

Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.