tci ED Coding & Reimbursement Alert - 2015 Issue 7

Reader Questions: Is It Critical For The Physician To Document A Full History For Code 99291?

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, they don’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…) without the elements that are required for the emergency department evaluation and management (E/M) 99281-99285 codes. Unlike the emergency department evaluation and management codes (99281-99285), with which the documentation needs to satisfy either CPT®...

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