# Hospital Coding Admission To Icu



## heatherwinters (Nov 19, 2008)

If A Patient Is Admitted To Icu From The E/d Would The Admitting Dr Code 99222 Or 99291 Or Both.  Thanks.


----------



## kevbshields (Nov 19, 2008)

The circumstances of the Admission to ICU would need explained further.

Either code may be appropriate--depending on if the provider documented time, if the patient's condition would fall into "critical care" and if the documentation was sufficient for the 99222 code.

However, please be aware that the fact that the patient was admitted to ICU is arbitrary in code assignment.


----------



## heatherwinters (Nov 19, 2008)

*Admitted To Icu*

Detailed History And Examination.  Admitted From Er For Moderately Severe Dka Manifested By Hyperglycemia, Ketonemia, Metabolic Acidosis.  Time Spent With Patient Documented As One Hour. Blood Glucose 711

I am thinking 99221, provider wrote ICU-99223 on billing summary sheet for me to bill.


----------



## Lisa Bledsoe (Nov 19, 2008)

If the time is documented correctly, couldn't you code 99222?


----------



## heatherwinters (Nov 19, 2008)

*Time*

Can I use the time component if he did not note that greater than half was spent counseling the patient?


----------



## FTessaBartels (Nov 21, 2008)

*99291*

For the VERY limited info you give I'm leaning towards coding 99291 - 1st hour of critical care.  And NOT coding the H&P.  You can only code one E/M for this service and 99291 will probably be most reflective of the work/risk that was involved.  Of course, I'd have to see the entire note to be sure. 

For billing of Critical care, you really only need to state that the patient was critically ill, what critical care treatment was provided, and the time spent face-to-face (includes unit/floor time in the inpatient setting) - which has to be 30 minutes or more. 

If the patient is a child under age 2 use the appropriate Inpatient Pediatric Critical Care code (99293 most probably).

F Tessa Bartels, CPC, CPC-E/M


----------

