tci E/M Coding Alert - 2013 Issue 5

Reader Question: ICU Does Not Automatically Support 99291-99292

Question: After a patient with chest pain “coded” in the ER and was admitted to the ICU, our cardiologist saw the patient for a cardiology consult. The patient was lethargic and a poor historian, so most of his information came from prior medical records. Our doctor did not document time. Can we charge for critical care since the patient was in the ICU? North Carolina Subscriber Answer: No — you can’t bill critical care (99291-99292, Critical care, evaluation and management of the critically ill or critically injured patient ...) simply because the place of service is the...

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