Wiki Facility Side Critical Care in the ED

[smrichards76]

Hello - I am having a difficult time determining when I can code 99291 (Crit Care) for the facility side of an ED Visit. I am not able to find coding guidelines for this. Could someone please share with me how you determine if Critical Care applies for the facility side.

 

[JennyMarie19]

You need to look at the hospitals policy for facility E/M charging. According to CMS, charging an E/M for facility is allowable, but only if there is a policy established by the hospital. CMS doesn't have a set policy like they do for profee E/M charging.

 

[shannonrobbins14]

If our ED Physicians documents "critical care time" (How many minutes) we then use that code. In their ED Note they will say " I spent ____ minutes providing critical care with this patient".