tci E/M Coding Alert - 2016 Issue 5

Clip N Save: Consider Critical Care When You Spot These Interventions

Don’t be fooled by interventions that are separately reportable from 99291/99292. It isn’t always easy to spot claims where you can rightfully report 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]). If a patient is deemed critically ill or injured, no matter the condition, then they might have received (codeable) critical care. One expert’s take: Someone who’s seen a lot of critical care claims is Caral Edelberg, CPC, CPMA, CAC...

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