Critical Care: 99291 vs. 99292: Check for Documentation of Time Before Selecting A Code

Why This Topic Matters

Accurate critical care reporting depends on both clinical documentation and time documentation. Understanding when related E/M services may also be reported helps reduce claim errors and support compliant billing.

Article Sections

1. Assess Patient’s Criticality

   Reviews the need to confirm that the patient’s condition meets the general standard for critical care. The section references CPT and CMS guidance and contrasts critical care with other E/M services.

2. Calculate Accurately Time Spent on Providing Critical Care

   Discusses how critical care time should be documented and summarized in the medical record. It also addresses how time devoted to care activities is considered for reporting purposes.

3. Don’t Miss Other Billable E/M services

   Explains the relationship between critical care and other E/M services furnished on the same day. The section includes a brief example involving hospital care and critical care reporting.