tci ED Coding & Reimbursement Alert - 2005 Issue 8

Reader Questions: Avoid 99293 for ED Care

Question: The parents of a 6-month-old girl brought her into the ED after she nearly drowned. The ED physician reported 35 minutes of critical care time, and the paramedics performed CPR. The doctor then transferred the child to another hospital. Usually I would report critical care code 99291 in a situation like this, but because the patient is only 6 months old, should I use 99293? Washington Subscriber Answer: According to CPT 2005, you should use codes 99291 (Critical care, evaluation and management of the critically ill or critically injured patient; first 30-74 minutes) and +99292 (... each additional...

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