Wiki billing critical care

[jfiorentino0807]

What is the correct way to bill critical care time for two pulmonary specialists, from the same group practice on the same calendar date?
two examples below:

Example 1 : Dr A saw patient and spent 30 mins in the morning with the patient. Dr B came in the afternoon and did an additional 32 mins CC time.


Example 2 : Dr A saw the patient and spent 30 mins in the morning with the patient. Dr B came in the afternoon and did an additional 45 mins of CC time.

Please help on how we should bill these two scenarios

thanks!

 

[kimberly514]

In both scenarios, Dr. A would bill 99291 and Dr. B would bill 99292.

 

[RebeccaCross*]

Palmetto GBA Example

Jurisdiction 11 Part B
E/M Weekly Tip: Critical Care Billing Same Specialty/Group

If a provider in the same specialty/group provides 'staff coverage' or 'follow-up' for each other after the first hour of critical care services was provided (same calendar date), the subsequent visits by the 'covering' provider in the group must be billed using CPT critical care add-on code 99292. The appropriate individual NPI number must be reported on the claim.

Example:
Drs. Smith and Jones, pulmonary specialists, share a group practice. On Tuesday Dr. Smith provides critical care services to Mrs. Benson who is comatose and has been in the intensive care unit for four days following a motor vehicle accident. She has multiple organ dysfunction including cerebral hematoma, flail chest and pulmonary contusion. Later on the same calendar date, Dr. Jones covers for Dr. Smith and provides critical care services. Medically necessary critical care services provided at the different time periods may be reported by both Drs. Smith and Jones. Dr. Smith would report CPT code 99291 for the initial visit and Dr. Jones, as part of the same group practice would report CPT code 99292 on the same calendar date if the appropriate time requirements are met.

http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Jurisdiction-11-Part-B~9B9K684470