Based on what you have stated, I believe what they are doing is likely incorrect. Critical care is not something that should be billed every time the provider spends a lot of time with a patient. The only way to appropriately get both an admit and critical care on the same date per CMS, is if the patient is admitted then later that day has an issue that qualifies/requires critical care.
If they are doing critical care, they should bill for critical care. If they are admitting a patient and it takes 3 hours they should bill the appropriate initial care code with the appropriate prolonged care code(s).
http://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/clm104c12.pdf
30.6.9 - Payment for Inpatient Hospital Visits - General
(Rev. 2282, Issued: 08-26-11, Effective: 01-01-11, Implementation: 11-28-11)
A. Hospital Visit and Critical Care on Same Day
When a hospital inpatient or office/outpatient evaluation and management service (E/M)
are furnished on a calendar date at which time the patient does not require critical care
and the patient subsequently requires critical care both the critical Care Services (CPT
codes 99291 and 99292) and the previous E/M service may be paid on the same date of
service. Hospital emergency department services are not paid for the same date as
critical care services when provided by the same physician to the same patient.
Hope this helps,
Laura, CPC, CPMA, CPC-I, CANPC, CEMC