Pulmonology Coding Alert
Reader Questions:
Turn to Individual Carriers for LMRPs
Published on Tue Sep 28, 2004
Question: Does CMS provide any information on critical care local medical review policies (LMRP)? Is there an LMRP for code 99291?
Missouri Subscriber
Answer: LMRPs specify the procedure or service and the clinical conditions and codes that cover those procedures and services.
Regional carriers formulated LMRPs for Medicare. You can find a good description of this process at www.hgsa.com, which is the CMS-contracted carrier for Pennsylvania.
You should contact your carriers to determine if they have an LMRP on 99291 (Critical care, evaluation and management of the critically ill or critically injured patient; first 30-74 minutes).
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