Critical Care / Subsequent Hosp Visit Feedback

Hi Group,

Doc peformed a critical care hospital visit. Four hours later partner in the same group went back to evaluate patient. He perfomed all requirements of a level 2 subsequent hosp visit. Can partner bill subsequent visit on same day as critical care visit?

I know in the reverse of the above situation it can be done.

Any feedback is always appreciated.

critical care

Doctors in same practice/specialty seeing a patient for critical care are considered one doctor for billing. Critical care is a per/day service. If the care is for a critical care management by both, then only bill one doctor with total time for both included.

critical care

This is what the manual says, and you can see it gives one example, but not the other.

H. Critical Care Services and Other Evaluation and Management Services
Provided on Same Day

When critical care services are required upon the patient's presentation to the hospital
emergency department, only critical care codes 99291 - 99292 may be reported. An
emergency department visit code may not also be reported.

When critical care services are provided on a date where an inpatient hospital or
office/outpatient evaluation and management service was furnished earlier on the same
date at which time the patient did not require critical care, both the critical care and the
previous evaluation and management service may be paid. Hospital emergency
department services are not payable for the same calendar date as critical care services
when provided by the same physician to the same patient.

Physicians are advised to submit documentation to support a claim when critical care is
additionally reported on the same calendar date as when other evaluation and
management services are provided to a patient by the same physician or physicians of the
same specialty in a group practice.