Wiki Critical Care - We have a patient

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scurtis7189

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Cheyenne, WY
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We have a patient who was admitted in the morning and then ended up having a procedure done. Our physician saw the patient prior to their procedure, and did an initial hospital visit (99223). The patient then had significant decline in their health status shortly after the procedure and was transferred to the ICU. Another physician in our practice saw the patient in ICU later that evening and wants to bill critical care time (99291). I'm not sure what the rules are when it comes to this situation. I know if one provider does 30 minutes of critical care time, and another provider from the same office provides additional critical care time on the same day, then it can be billed using the (99292) code if time criteria is met. However, this circumstance is new to me.

Any help would be appreciated!

Thank you!
 
Just seeing the patient in ICU does not qualify for critical care. Look in your CPT book for all of the required elements of critical care.
 
If all of the required elements are there, can it be billed that way? The same date of service? 99223 billed by one physician in our practice and 99291 billed by another?

Thank you for your help!
 
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