tci ED Coding & Reimbursement Alert - 2006 Issue 7

Reader Questions: Beware Bundled Services on Critical Care Claims

Question: Our ED physician performed 64 minutes of critical care on a patient in cardiac arrest. During the encounter, the physician also took a chest x-ray and performed ventilatory management. Can we report the chest x-ray and the ventilatory management separate from the critical care?Minnesota Subscriber Answer: In this scenario, you can only report the critical care service. According to CPT, chest x-rays (CPT codes 71010, 71015, 71020) and ventilatory management (94656, 94657, 94660, 94662) are bundled into critical care codes. On the claim, you should: - report 99291 for the critical care - attach ICD-9 code...

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