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CAPC Palliative Care Discussion Forum
Billing and Finance

Next Reply: Re:Critical Care Coding for Palliative Care
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Post Critical Care Coding for Palliative Care
Author: Lustbader
Date: May 30, 2012 3:50 pm
Some of our critical care codes (99291) from palliative care docs are colliding with the intensivists coding 99291 on services provided to same patient in same day. We are all listed as critical care specialty with CMS.

Shall the palliative care/critical care docs change specialty to palliative care alone? Would coding 200-300 critical care codes per year raise eyebrows as a palliative care specialist (.e. outlier behavior worth punishing)?

How do others handle this problem? Using the 99292 subsequent 30 mins code is difficult since we rarely know how other providers are coding. No way of knowing if they used 99291 or simply 99233 for their services.

Dana Lustbader MD
Replies: order by [Date] [Author] [Subject]
Re:Critical Care Coding for Palliative Care (by JulieP on 05/31/2012)
Dana, any reason why the Palliative Care providers are set up with Critical Care as your specialty with CMS? If you don't want to change your specialty, you'll have to bill 99291 & 99292 and if your services are denied you'll have to rebill CMS with only 99292 as appropriate for the time you spent. I think Palliative Care providers billing for critical care is a fairly new concept. I think it's likely to get some attention, but not if your specialty with CMS is other than Hospice/Palliative Care.
Julie Pipke, CPC
CAPC Consultant

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