CRITICAL CARE: Follow This FAQ to Maximize 99291 Coding

Why This Topic Matters

Critical care claims are closely scrutinized because they depend on meeting both patient-condition and time-based requirements, along with proper documentation of physician work. Understanding the scope of included and excluded services helps support cleaner claims review and more consistent coding practices.

Article Sections

1. Who Qualifies for Critical Care?

   This section discusses the general clinical and documentation factors used to determine whether a patient encounter may be considered critical care under CPT. It also introduces the time-based framework associated with critical care reporting.

2. What's Included in Critical Care?

   This section reviews broad categories of services discussed as part of the critical care service and notes that some related procedures are not separately reported in this context. It also references the types of services that may be reported separately when they are not included in the critical care work.