tci ED Coding & Reimbursement Alert - 2010 Issue 15

READER QUESTIONS: Ensure Critical Care Before Choosing 99291

Question: The ED physician treats a patient suffering from critical gastrointestinal hemorrhaging. Notes indicate that the physician took 28 minutes to perform gastric aspiration in order to determine the location of the bleeding and lavaging blood from the injury, and another 15 minutes stabilizing the patient. Is this a 99291 scenario? Are there any separately reportable services? Illinois Subscriber Answer: If your physician provided critical care in this scenario, it warrants one CPT code. On the claim, report the following: • 99291 (Critical care, evaluation and management of the critically ill or critically injured patient; first 30-74 minutes) for...

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