tci ED Coding & Reimbursement Alert - 2005 Issue 7

You Be the Coder: Consider Time - Not E/M Elements - for Critical Care

Question: Does the ED physician need to complete all the HPI, ROS, history, and exam elements in order to bill for critical care time?New Mexico Subscriber Answer: No, he doesn't. You can bill critical care codes 99291 (Critical care, evaluation and management of the critically ill or critically injured patient; first 30-74 minutes) and +99292 (... each additional 30 minutes [list separately in addition to code for primary service]) without the elements that are required for general emergency department E/M codes.Unlike the emergency department E/M codes (99281-99285), with which the documentation needs to satisfy either CPT or...

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