TWilliam2019
Guru
Can you code a code a level 5 consult code and a critical care 1 hr together? new to coding just wanting to double check. thanks
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Wiki e/m plus cc
- Thread starter TWilliam2019
- Start date
Misty Dawn
Guru
If they were done at different times then yes. For example if the doctor consulted on a patient and then later that day they went to hypotensive shock or vfib....then you could also code for the critical care time. If the consult and critical care time were at the same time then you would only bill for the critical care time. Also at least for medicare you can not bill for Critical care time done first and then a E/M visit later that day. I attached a couple of the sites I have saved to reference when billing CC time. (Note: Make sure your doctor dictates the time or you can not code CC time at all.)
the below is from: http://thehappyhospitalist.blogspot.com/2011/09/can-you-bill-for-critical-care-after.html
What about critical care? Medicare will pay you if you provide an E/M charge (such as admit or follow-up code) followed by a critical care code if documentation supports the need to come back later for a separate and identifiable face-to-face-encounter for critical care services. This critical care time provided must be 30 minutes or more to bill CPT® 99291 and 75 minutes or more to add on the CPT® 99292 code as well. Therefore, it's possible to submit an admit code 99223, a critical care code 99291 and an unlimited number of critical care 99292 add on codes in the same calendar day if you provided the work for 99223 before you provided the critical care work.
However, you cannot bill a critical care code first, and then bill an additional E/M charges (such as the 99223 or in the case here, a discharge code 99238 or 99239, after the critical care time. The only recognized code that can be billed after work for a 99291 is provided, is the 99292 add on critical care code. All work past the first 74 minutes of critical care time must be billed at 99292.
Also see:
http://www.cms.gov/Outreach-and-Edu...k-MLN/MLNMattersArticles/downloads/mm5993.pdf
the below is from: http://thehappyhospitalist.blogspot.com/2011/09/can-you-bill-for-critical-care-after.html
What about critical care? Medicare will pay you if you provide an E/M charge (such as admit or follow-up code) followed by a critical care code if documentation supports the need to come back later for a separate and identifiable face-to-face-encounter for critical care services. This critical care time provided must be 30 minutes or more to bill CPT® 99291 and 75 minutes or more to add on the CPT® 99292 code as well. Therefore, it's possible to submit an admit code 99223, a critical care code 99291 and an unlimited number of critical care 99292 add on codes in the same calendar day if you provided the work for 99223 before you provided the critical care work.
However, you cannot bill a critical care code first, and then bill an additional E/M charges (such as the 99223 or in the case here, a discharge code 99238 or 99239, after the critical care time. The only recognized code that can be billed after work for a 99291 is provided, is the 99292 add on critical care code. All work past the first 74 minutes of critical care time must be billed at 99292.
Also see:
http://www.cms.gov/Outreach-and-Edu...k-MLN/MLNMattersArticles/downloads/mm5993.pdf