Pulmonology Coding Alert

Question: May two physicians from the same group charge for critical care on the same day for the same patient? Would this fall under concurrent care?

Florida Subscriber Answer: Although two physicians from the same group can qualify for concurrent care in limited situations, these rules do not apply to critical care services. The circumstances of the physicians' services will help you decide whether you can bill for critical care for both physicians.

What to do: Three rules may help you understand when two physicians should bill for critical care on the same day:

1.  The physicians must be of different specialties or subspecialties.
2.  They have to use two different primary ICD-9 codes.
3. They must bill for critical care during different time periods. Multiple physicians from the same practice may report critical care services if the cumulative time 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 99291 service (Critical care, evaluation and management ...).