tci Medicare Compliance & Reimbursement - 2008 Issue 16

Coding Coach: Watch For Life-Threatening Conditions Before Reporting 99291-99292

Hone your critical care coding skills now and avoid denials later Your physician documents that a patient suffered a serious "critical" injury and underwent major surgery. You should report a critical care code along with the procedure code because the patient was critically ill, correct? Wrong. You must meet all three of the following key criteria to report critical care services:1. The patient must meet the definition of critically ill or critically injured. A critical illness or injury acutely impairs one or more vital organ systems such that there is a high probability of imminent or life-threatening deterioration in...

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