critical care

  1. D

    Wiki 99471 vs 99472 when pt ages from 28 to 29 days

    I cannot find this answer anywhere. The neonate has received critical care throughout 28 days of life, the subsequents billed as 99469. But when the pt is 29 days old and receives CC, do I bill a 99471 or a 99472 for the infant/pediatric code set? I don't know if it's considered an initial or...
    • dillerisev
    • Thread
    • critical care neonatology pediatrics peds critical care
    • Replies: 1
    • Forum: Pediatrics
  2. R

    Wiki Facility Critical Care Charging?

    If our nursing staff documents 120 minutes of critical care time, but our physician only documents 35 minutes of critical care time, can we bill facility charges 99291 x 1, 99292 x 2, even though the physician is limited to 99291 x 1?
  3. R

    Wiki Split/Shared Critical Care 2022

    Hello, With the new split/shared services modifier FS that applies to critical care, I have a question regarding when and when not to use the FS modifier. We told our critical care PA's and NP's to stop documenting their CC time years ago, because the MD was also documenting critical care time...
  4. K

    Wiki Critical Care Denial

    I'm working on a denial for a patient that saw two of our intensivists in the ICU on the same day. Dr. A saw patient 1st for just under 74 minutes so we billed 99291; Dr. B saw patient second so we charged 99292. This is how we have always billed critical care and we've had no issues with...
  5. V

    Wiki Critical Care + Chest Tube Placement

    Hello, Friends! I've searched online and I can't find CURRENT advise re: the following scenario Provider performed critical care services for a patient for 90 minutes (99291 + 99292) and also performed a chest tube insertion (32551). I understand 99291 + 99292 does not require modifier...
    • venitacason
    • Thread
    • chest tube critical care modifier 25 modifier lt/rt
    • Replies: 1
    • Forum: Modifiers
  6. M

    Wiki Please help on FAST Scans (76705 & 76775)

    We are running into a bit of a confusion at work regarding the FAST scans for the following -76705: Ultrasound, abdominal, real time with image documentation; limited (eg, single organ, quadrant, follow-up) -76775: Ultrasound, retroperitoneal (eg, renal, aorta, nodes), real time with image...
  7. A

    Wiki Post-Op External Pacing

    Good Morning! Is there a cpt code for post-op *external* pacing of a 3rd degree heart block? Background: The patient is 16 day s/p TGA Transposition and VSD repair w a resultant 3rd degree heart block. Atrial and Ventricular pacing wires were placed during the procedure and the patient's...
  8. E

    Wiki 99477 - Newborn Transfer of Care

    Hello, Is it appropriate to charge 99477 when a baby is born, admitted, and transferred to a different facility on the same day? We are a CAH and deliver many babies but do not have a NICU, so we sometimes have to transfer newborns to a facility with a higher level of care. The provider does...
  9. christinav

    Wiki Critical Care Audit Question

    I am currently auditing Critical Care Services and there is a physician who provides the EHR signed document that does not indicate that it is a Critical Care document, but will then Write using a normal pen on the bottom of the last page stating the total time spent providing critical care...
  10. S

    Wiki Critical Care documenting by ED physician

    With Critical Care codes being time based can the provider document Critical Care time and that plus the medical necessity evidenced by the diagnosis be enough to constitute Critical Care? Is the fact that they ordered intervention (labs/tests/intubation/etc) enough to show the intervention or...
    • stephaniehughes
    • Thread
    • critical care documentation e/m
    • Replies: 2
    • Forum: E/M
  11. L

    Wiki Physician not reporting critical care time

    I have a problem with a physician in our ED not reporting his critical care time so the facility can report it for the revenue. I am trying to find documentation on CMS or any other supporting site to take with me to Quality Assurance to let them know manipulating documentation for maximum...
  12. P

    Wiki critical care robot

    Some of my doctors are trying to use the time they spend "at bedside" on a robot towards critical care. I don't think this should be used, but I'm having a hard time finding resources to back me up. Outside of the CPT saying the physician must be "immediately available to the patient" (because...
    • perfectblues
    • Thread
    • critical care robot video assisted
    • Replies: 1
    • Forum: E/M
  13. V

    Wiki Neonatal Critical Care + Consult Codes

    Good afternoon, Scenario 1 When a neonatal patient (<28-days) requires critical care services (99468, 99469) and the critical care physician requests a consult from a physician of a different group and different specialty - what CPT would the consulting physician submit? Would the requesting...
  14. M

    Wiki Critical Care help!

    I have been working with the provider for a year now because noone else has been able to get through to him. I have presented numerous articles along with cpt guidelines and CMS guidelines but he is set on billing critical care. I have problems with most of the notes he is billing and would...
    • MandyFlagg
    • Thread
    • critical care e&m critical
    • Replies: 5
    • Forum: E/M
  15. M

    Wiki Critical Care with DNR

    I have a question regarding Critical Care coding. A patient who came from the ED who is in Acute Resp Failure and was transferred to the ICU intubated and on vent, can the pulmonary physician who was asked by the hospitalist to see the patient in the ICU code for critical care? Also, if the...
    • mony94803
    • Thread
    • critical care dnr
    • Replies: 0
    • Forum: E/M
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