Practice Management Alert
Did the Doctor Provide Critical Care? You Decide
Check previous pages of this issue for critical care tips Critical care? Yes_____ No______ Scenario 2: An allergist travels to the hospital to meet her patient, who is having an adverse reaction to a bee sting. The patient is wheezing, has very low blood pressure and appears to be in shock. Critical care? Yes_____ No______
This month's Medical Office Billing & Collections Alert features a pair of stories containing expert advice for billers navigating the tricky waters of critical care. With that advice in mind, try your hand at this quiz.
For each of the following scenarios, decide whether or not the physician provided critical care, and check -Yes- or -No- based on your answer.
If you want an added challenge, try to explain why any -No- answers were not critical care scenarios. Then, refer to the answers below.
Scenario 1: A gastroenterologist treats a patient with liver cirrhosis for severe gastrointestinal bleeding. The patient is hemorrhaging heavily, and the physician takes several minutes to find the bleeding's origin.
During the encounter, the physician provides continuous care to the patient. In the course of 49 minutes, he lavages blood from the patient, conducts several tests and consults with another physician on the patient.
The allergist spends 26 continuous minutes providing E/M service to the patient, and also provides injections of acetate and epinephrine to the patient.
After 26 minutes, the patient stabilizes.
Quiz Answers:
Scenario 1 answer: Yes.
Scenario 2 answer: No. The allergist did provide critical care services, but not for the 30 minutes required to bill 99291. When critical care encounters do not total 30 minutes, report a high-level evaluation and management code instead.
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Did the Doctor Provide Critical Care? You Decide
Check previous pages of this issue for critical care tips
This month's Medical Office Billing & [...]
