tci ED Coding & Reimbursement Alert - 2001 Issue 6

Avoid Undercoding: Choose Critical Care Instead of 99285

CPT 2001 has broadened the definition of 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]). The revised introduction to critical care now reads, A critical illness or injury acutely impairs one or more vital organ systems such that there is a high probability of imminent or life-threatening deterioration in the patients condition. The new definition adds high probability to the CPT 2000 language (which itself had been altered to eliminate a prior requirement that...

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