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Critical Care Codes Documentation

Critical Care Codes Documentation

Critical Care Codes Documentation

Critical care is not only extremely important to save lives, but is also important in medical billing. Only the most experienced medical billers understand how to bill critical care correctly. There are several rules one should keep in mind when doing medical billing for a critical care patient.

The two critical care Current procedural terminology codes are 99291 (Critical care, evaluation and management of the critically ill or critically injured patient; first 30-74 minutes) and 99292 ( each additional 30 minutes). Obviously, these codes are only appropriate for medical billing when there is a critically ill or injured patient. However, this can be more difficult to spot than you might think.

The current procedural terminology states that the word critical is defined by acutely impaired vital organs where there is a high probability of imminent or life threatening deterioration in the patient’s condition. Also, in medical billing, the physician attending to this patient must only be attending to the patient in this timeframe.

In order for a payer to deem the critical care medical billing codes as medically necessary, two things must be present: time, and documentation. When a patient’s life is at stake, usually the last thing on everyone’s minds is how much time is spent in care. However, it is necessary for a medical billing claim to show that at least 30 minutes are spent on the patient by the physician.

The other thing you need is documentation. This documentation must show that the patient was exclusively seen by the physician during that timeframe and that separately billable procedures are not included in the 30 minute allotment.

Critical care is necessary to save lives. Critical care documentation is necessary to get reimbursed for services. Medical billing procedures may not seem important during medical care, but it is necessary to document time and information that shows medical necessity.

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