tci E/M Coding Alert - 2016 Issue 1

Reader Question: No Hospice Employment Relationship? Use GV

Question: A patient at a local hospice care facility with terminal lung cancer was having heart palpitations, so she was rushed to our emergency department (ED). The ED physician performed 37 minutes of critical care, and five minutes of cardiopulmonary resuscitation (CPR), before the patient stabilized. I’m not sure how to code this encounter, since our ED physician doesn’t work for the hospice. How should I proceed? Tennessee Subscriber Answer: For optimal coding, you’ll need a pair of modifiers for this encounter. On the claim, report 99291 (Critical care, evaluation and management of the critically ill...

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