Pulmonology Coding Alert

Question: Our pulmonologist saw a patient in the morning for a critical care service. Later the same day, a different doctor, who was on-call, saw the same patient for critical care services. I know that I should add up the time if both services were provided by the same physician. But how should I bill when one doctor signs off to another doctor in the same practice and the second doctor gets called in to see the patient? The total time between the two physicians was 74 minutes.

North Carolina Subscriber

Answer: Multiple physicians from the same practice can report critical care services if the cumulative time for each physician equals at least 30 minutes. You need to report all services together, however, and bill under one physician in the group, usually the physician who provided the initial critical care service.

You say that the total critical care time was 74 minutes. Suppose the first doctor performed 40 minutes of critical care services on a patient with respiratory failure at 9 a.m. Later that day, another doctor in the same practice performed 34 minutes of critical care on the same patient. In this case you should bill 99291 (Critical care, evaluation and management of the critically ill or critically injured patient; first 30-74 minutes) under the first doctor's personal identification number. Also, remember that Medicare will not pay for more than one physician reporting critical care services in any given hour.