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ED Coding and Reimbursement Alert

Reader Question:

You might be the lone "ranger" if not using a specific critical care time statement.

Published on Wed Mar 21, 2012

Question: Would a template listing a range of time spent rather than a specific time statement providing critical care time be acceptable for documenting the duration of service?Utah SubscriberAnswer: The templated time range concept may sound attractive, but proceed with caution. The critical care section of CPT® does include a chart of time ranges as a guide for which code or codes should be used to report the duration of critical care provided. For example, if the total duration of critical care was 75-104 minutes (1 hr. 15 min. - 1 hr. 44 min.), the appropriately assigned E/M codes would be 99291 and 99292. If you were to consider a templated set of ranges, it would be best to mirror those in the CPT® chart. Any other time ranges would create more problems than they would solve. However, some payers, including Medicare, want a specific time statement along the lines [...]
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