Pulmonology Coding Alert

Question: Sometimes patients see two of our physicians on the same day. Can I report both E/M services?


Nebraska Subscriber
Answer: You cannot report two E/M services for one patient on the same day if the patient sees two physicians in the same group practice, regardless of subspecialty assignment. When this occurs, you can pool the documentation of each physician and report the cumulative service under one physician name.

Example: A physician sees a patient in the hospital for respiratory failure and provides 50 minutes of critical care services. Later in the day, the patient decompensates, requiring the on-call pulmonologist (from the same group) to provide 35 additional minutes of critical care services.

Report the two services as a cumulative 85 minutes of critical care time under the first physician's name using 99291 (Critical care, evaluation and management of the critically ill or critically injured patient; first 30-74 minutes) and +99292 (... each additional 30 minutes [list separately in addition to code for primary service]).