tci ED Coding & Reimbursement Alert - 2008 Issue 3

Prove Patient's Critical State Before Coding 99291

- and remember to report nonbundled services separately When a patient presents with a serious injury or medical condition, ED coders should be on the lookout for critical care services the physician might provide. After all, these codes sport higher relative value units (RVUs) than standard E/M codes. But be careful you don't miscode a claim in your zeal to use the high-RVU critical care codes. You-ll have to prove that the patient needed critical care services before considering 99291 (Critical care, evaluation and management of the critically ill or critically injured patient; first 30-74 minutes) or +99292 (...

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