Evaluation and Management/Critical Care Services (July 2009)
July 2009 page 10
Evaluation and Management: Critical Care Services, 99291 (Q&A)
Question: If a patient is in a critical care unit, is it always
appropriate to report the critical care codes?
Answer: No. The use of critical care codes is dependent upon the
services received as required by the critical nature of the patient's condition, not
merely the fact that the patient is admitted to the critical care unit. Services for a
patient who happens to be in a critical care unit, but is not critically ill are
reported using other appropriate E/M codes (eg, initial or...
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Note: The following article synopsis was NOT provided by the AMA. It was created by Find-A-Code/innoviHealth.
Article Overview
This article addresses a July 2009 CPT Assistant question-and-answer item on evaluation and management services in the critical care setting. It is intended for coding and compliance audiences who need to understand the scope of critical care reporting versus other hospital E/M services at a high level.
Why This Topic Matters
It helps readers distinguish between location of care and the clinical basis for reporting critical care services, which is important for accurate evaluation and management coding.
Article Sections
July 2009 page 10
A brief Q&A item from CPT Assistant focusing on critical care services in the inpatient setting and the broader relationship to hospital evaluation and management reporting.
What You Will Learn
The article’s focus and format within a CPT Assistant Q&A item
How the topic relates to evaluation and management services in a critical care setting
The type of coding issue addressed for hospitalized patients at a high level
Why clinical context matters when considering critical care reporting
Who Should Read This
Medical coders
Coding auditors
Compliance staff
Revenue cycle professionals
Physician documentation staff
Codes Discussed
CPT: 99291
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