tci ED Coding & Reimbursement Alert - 2023 Issue Q2

Reader Questions: Check Payer Policy Before Critical Care Coding

Question: Encounter notes indicate that the ED physician performed 75 minutes of critical care for a patient, along with interpretation of a complete chest X-ray and ventilatory management. The chest X-ray interpretation and ventilatory management took an additional 18 minutes. How should I code for this encounter? Are the X-ray and vent management separately reportable? Connecticut Subscriber Answer: The X-ray interpretation and vent management are bundled into the critical care, meaning you have 93 total minutes of critical care to code. Choosing a code is going to depend on the payer, however. Payers that follow CPT® guidelines differ...

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