tci Part B Insider - 2009 Issue 10

CRITICAL CARE: Follow This FAQ to Maximize 99291 Coding

Physician 'preventing further deterioration' keys valid critical care claims. What do critical care services need to contain to withstand scrutiny? The service has to meet CPT's time parameters, patient condition, and physician actions requirements. Checking encounter notes for these items just got easier, thanks to solutions on critical care's "who, what, and where?" Who Qualifies for Critical Care? To report 99291 (Critical care, evaluation and management of the critically ill or critically injured patient; first 30-74 minutes) and +99292 (... each additional 30 minutes [List separately in addition to code for primary service]), the physician must be treating...

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