tci ED Coding & Reimbursement Alert - 2005 Issue 8

Reader Questions: Require Physician Statement for CC

Question: A very dramatic patient presented to the ED with intense stomach pain, diaphoresis, and a heart rate of 150. The physician spent 35 minutes in direct care with a seemingly critical case. Ultimately, after significant bedside care, the pain abated with a GI cocktail, and one of the final diagnoses was GERD in addition to chest pain and abdominal pain. Could we consider this a critical care case? Does the final diagnosis influence or determine the level of service we can report?Minnesota Subscriber Answer: First, to report 99291 (Critical care, evaluation and management of the critically ill...

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