Oncology & Hematology Coding Alert

Don't let condition alone lure you into reporting 99291. You can maximize your E/M coding by grasping the "who" and "what" behind critical care. The service has to meet CPT's time parameters, patient condition, and physician action requirements. So check your encounter notes for the items below. What Is Critical Care? For coding purposes, a patient must be critically ill or injured for you to report critical care services. "Critically ill or injured patients have one or more vital organ systems acutely impaired, such that there is a high probability of imminent or life threatening deterioration in the patient's condition" if the physician does not intervene, explains Deb Williams, CPC, coding supervisor at Horizon Billing Specialists in Grand Rapids, Mich. The physician must spend at least 30 minutes providing critical care before you can code for it, however. Note the time requirements in the code descriptors: 99291 -- Critical care, evaluation [...]