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Pulmonology Coding Alert

Reader Question:

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

Published on Sun Nov 25, 2012

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 [...]
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