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tci ED Coding & Reimbursement Alert - 2022 Issue Q4

Reader Questions: Don’t Ever Do This With Short Critical Care Sessions

Question: Encounter notes indicate that the physician provided 23 minutes of critical care. Can I code this as critical care with modifier 52 appended? Arizona Subscriber Answer: Absolutely not. First, you need a minimum of 30 minutes of critical care time in order to report 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)). Second, modifier 52 (Reduced services) is a procedural modifier, meaning you cannot use it on evaluation and management (E/M) codes. Do...

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