![]() ![]() Please see the below grid for reference:ĩ922 as appropriate (see illustrated examples above)Ħ. An additional 99292 is reported for each additional 30-minute block of time reached.įor CMS, starting with CY 2023, 99292 can only be reported when the full additional 30 minutes of critical care time has been provided (74 minutes + 30 minutes = 104 total minutes). If the total critical care time is in the 75-104 minute range, 99292 is reported in addition to 99291. Code 99292 is reported when the total critical care time extends beyond the initial 74 minutes allotted by 99291. ![]() How is physician/QHP time counted to determine the correct critical care code(s)?įor CPT, code 99291 is used to report the first 30-74 minutes of critical care on a given date. The daily neonatal (99468-99469) and pediatric (99471, 99472, 99475, and 99476) critical care codes are only used in the inpatient setting.Ĥ. Only the time-based critical care codes (9922) may be reported for services in the ED. Such service should be reported using the appropriate E/M code. It should be used only once per date. Critical care time of less than 30 minutes is not reported using the critical care codes. CPT code 99291 is used once a minimum of 30 minutes of critical care services are provided on a given date. Non-continuous time for critical care services may be aggregated for a single date. The critical care codes 9922 are used to report the total duration of time spent by a physician and QHP providing critical care services, even if the time spent by the physician/QHP on that date is not continuous. The "critical care accrual clock" pauses when separately reportable procedures or services are performed these should not be included in the total time reported as critical care time. The time involved in activities that do not directly contribute to the treatment of the critical patient may not be counted toward the critical care time. For example, time spent can be at the bedside, reviewing test results, discussing the case with staff, documenting the medical record, and time spent with family members (or surrogate decision makers) discussing specific treatment issues when the patient is unable or clinically incompetent to participate in providing a history or making management decisions. Physician/QHP time for critical care services encompasses time spent engaged in work directly related to the individual patient’s care, whether that time was spent at the immediate bedside or elsewhere. This time may be spent at the patient’s immediate bedside or elsewhere on the unit, so long as the physician is immediately available to the patient. During each moment of this accrued total time, the physician/QHP must devote full attention to the particular patient. The duration of critical care services is based on the physician/QHP’s documentation of the total time spent evaluating, managing, and providing care to the critical patient, as well as time spent documenting such activities. ![]()
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