Prolonged services and Critical care

Hello,


We have some providers that are billing a 99291 with 99358. We do not feel this is appropriate but felt we should get a second opinion. What is your take on this?

Thank you!!

nope!

can't be done- use the add on code for critical care- cannot link prolonged to critical care services- I'll look for the citation

here is the list

https://www.cms.gov/transmittals/downloads/R1490CP.pdf

it lists the codes that are eligible for using prolonged sevices

Thanks

Thank-you so much for your reply. It helps having the list of companion evaluation and management codes for the prolonged services.

prolonged services

If you search the word "prolonged" in the search box, you'll find some articles in Codapedia on the subject.

http://www.codapedia.com/-article_151_.cfm

http://www.codapedia.com/-article_416_.cfm

http://www.codapedia.com/-article_415_.cfm

http://www.codapedia.com/-article_224_.cfm

99291

99291 Critical Care is TIME based. 99291 is for 30-74 minutes (1 hour and 14 min). If the doc spent LONGER, you add a 99292 for each additional 30 minutes. Examples below:

30-74 min 99291
75-104 min 99291 + 99292
105-134 min 99291 + 99292 X2

Hope this helps!!!!