# Critical care billing



## debra_butler@urmc.rochester.edu (Jan 14, 2014)

Does Medicare allow critical care code 99291 to be billed with code 33010. Thanks


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## CDREVERS (Jan 14, 2014)

It's bundled but allowed with modifier if supported per CCI rules. Medicare may reject due to the CCi edit and you'd have to appeal with notes if supported.


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## OCD_coder (Jan 14, 2014)

The 33010 is not listed as one of the inclusive procedures to critical care by CPT (See below), but it does bundle together.

The documentation for the Critical Care CPT code needs to clearly stated the time spent providing critical care and....."exclusive of procedures" to let the carrier know that the time spent performing the 33010 was not included.  A modifier 25 is needed to separate the E&M from the procedure code.

Critical Care Services 99291-99292 

Codes 99291, 99292 should be reported for the attendance during the transport of critically ill or critically injured patients older than 24 months of age to or from a facility or hospital. For transport services of critically ill or critically injured pediatric patients 24 months of age or younger, see 99466, 99467. 
For reporting by professionals, the following services are included in critical care when performed during the critical period by the physician(s) providing critical care: the interpretation of cardiac output measurements (93561, 93562), chest X-rays (71010, 71015, 71020), pulse oximetry (94760, 94761, 94762), blood gases, and information data stored in computers (eg, ECGs, blood pressures, hematologic data [99090]); gastric intubation (43752, 43753); temporary transcutaneous pacing (92953); ventilatory management (94002-94004, 94660, 94662); and vascular access procedures (36000, 36410, 36415, 36591, 36600). Any services performed that are not included in this listing should be reported separately. Facilities may report the above services separately. 
Critical care and other E/M services may be provided to the same patient on the same date by the same individual. 
Services for a patient who is not critically ill but happens to be in a critical care unit are reported using other appropriate E/M codes.


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