Pulmonology Coding Alert

Reader Question:

Know When You Can Report an E/M Service Along With Critical Care Services

Question: My doctor saw a new patient in the office (99205) and then decided to admit her to the ICU. When he saw the patient later that same day, he documented and billed 99291. How do we bill both procedures, so they are both paid?   New Jersey Subscriber Answer: There are certain circumstances during which you can bill an E/M service and the critical care services together. The first and foremost thing is that your doctor should have completed two separate services, the standard E/M service prior to the critical care services provided. So, if your physician performed all the components described by the descriptor of the E/M service prior to care provided in the ICU which lasted a minimum of 30 critical care minutes, you can bill both the services together. It is also important that all other guidelines for reporting critical care services should be met for [...]
You’ve reached your limit of free articles. Already a subscriber? Log in.
Not a subscriber? Subscribe today to continue reading this article. Plus, you’ll get:
  • Simple explanations of current healthcare regulations and payer programs
  • Real-world reporting scenarios solved by our expert coders
  • Industry news, such as MAC and RAC activities, the OIG Work Plan, and CERT reports
  • Instant access to every article ever published in Revenue Cycle Insider
  • 6 annual AAPC-approved CEUs
  • The latest updates for CPT®, ICD-10-CM, HCPCS Level II, NCCI edits, modifiers, compliance, technology, practice management, and more