ED Coding and Reimbursement Alert

The CPT^® critical care preamble includes a specific list of services that are bundled in to code 99291 and should not be reported separately. These include the following:

• The interpretation of cardiac output measurements (93561, 93562);
• Pulse oximetry (94760- 94761, 94762);
• Chest x-rays, professional component (71045, 71046);
• Blood gases, and information data stored in computers (e.g., ECGs, blood pressures, hematologic data (99090);
• Gastric intubation (43752-43753);
• Temporary transcutaneous pacing (92953);
• Ventilator management (94002-94004, 94660, 94662); and
• Vascular access procedures (36000, 36410, 36415, 36591, 36600).

When your physician provides any of the above services during a critical care session, do not report them separately. However, facilities can report these services separately.

Non-bundles:  However, you can report the below services separately from 99291 and +99292, as they are not bundled into critical care:

• CPR (92950);
• Endotracheal intubation (31500);
• Tube thoracostomy (32551);
• EKG interpretations (93010, 93042); and
• Central venous catheter placement (36555, 36556).