ED Coding and Reimbursement Alert

Carefully documented time and resources spent is the key to accurate facility coding Identifying and reporting the hospital component of ED critical care presents a challenge for hospitals as the rules differ enough from the professional rules to create a significant challenge. This is especially true when the hospital's trauma team is activated to deal with a critical injury presentation. As of January 1, 2007, critical care services were paid at two levels, depending on whether or not there was also activation of the hospital's trauma team. Hospitals will receive one payment rate for critical care without trauma activation and will receive additional payment when critical care is associated with trauma activation. When critical care services are provided without trauma activation, the hospital may bill CPT® code 99291, (Critical care, evaluation and management of the critically ill or critically injured patient; first 30-74 minutes). If additional critical care time is [...]