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Pulmonology Coding Alert

Report Critical Care With Confidence

Published on Wed Jan 21, 2004

 We'll show you when to use 99291 instead of 99205

Review these three key points to remember when you should report critical care services:

 

  •  CPT defines a critical illness or injury as one that impairs one or more vital organ systems. This creates a high probability of imminent or life-threatening deterioration in the patient's condition.

     
  •  Remember that critical care involves high-complexity decision-making used to assess, manipulate and support vital system function(s). In critical care, the physician treats single or multiple vital organ system failure(s) and/or prevents further life-threatening deterioration of the patient's condition for at least 30 minutes.

     
  •  The physician does not usually provide these services in the office for an extended time. He or she may perform them until the patient can be transported to a hospital or critical care unit.

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