tci E/M Coding Alert - 2013 Issue 7

Critical Care: Focus on Patient Condition When Deciding on 99291/99292

Tip: Get your provider to spell out time spent. Whether your providers perform critical care services once a year or once a day, if you only look for the place of service and not the patient’s condition, you’ll set yourself up for inappropriate billing of critical care codes. Read on to know more about when you can bill critical care services and other associated services provided to the same patient on the same day. Assess Patient’s Criticality Ensure that the patient’s condition qualifies as critical. CPT® guidelines state that “critical care is the direct...

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