CPT® 99291, Under Critical Care Services

The Current Procedural Terminology (CPT®) code 99291 as maintained by American Medical Association, is a medical procedural code under the range - Critical Care Services.

Subscribe to Codify by AAPC and get the code details in a flash.

Tabs
Summary

Critical care services include the treatment of vital organ failure  or prevention of further life–threatening conditions. Delivering medical care in a moment of crisis and in time of emergency is not the only requirement for providing CC services. Presence of a patient in an ICU or use of ventilation is not sufficient to bill a CC service. The following three criteria must be met for reporting CC service:  

the severity of illness the intensity of services required to treat the illness, and the time spent in providing the care.

Proper documentation showing the medical necessity for providing CC services is an absolute requirement.

Usually a critical care service is provided to a patient in a "critical care area" such as the coronary care unit (CCU), intensive care unit (ICU), respiratory care unit, or emergency room.

This code is applicable for a critical care service provided for first 30 – 74 minutes. Any CC service provided for less than 30 minutes should be billed with the appropriate level of E/M code.

For clinical responsibility, terminology, tips and additional info
start codify free trial.

View any code changes for 2024 as well as historical information on code creation and revision.
Tabs
Combat the #1 denial reason - mismatched CPT-ICD-9 codes - with top Medicare carrier and private payer accepted diagnoses for the chosen CPT® code.
View the CPT® code's corresponding procedural code and DRG. In a click, check the DRG's IPPS allowable, length of stay, and more. To plug inpatient facility revenue drains, subscribe to DRG Coder today.
Crosswalk to an anesthesia code and its base units, and calculate payments in a snap! Subscribe to Anesthesia Coder today.
View matching HCPCS Level II codes and their definitions.

Forum

Have a question about CPT Code 99291 ? Start a discussion here