Can I bill for a subsequent visit and time-based critical care on the same patient?
by Grant Christman - Only if the patient's condition changes during the shift.
Here is one scenario where it could work. You round on the patient in the morning, and she is stable / non-critical. You write a progress note and bill a level 3 subsequent visit 99233.
In the afternoon, she decompensates and an RRT is called. You provide 30 minutes of critical care during and after the RRT. You write a separate event note documenting the critical system failure, interventions provided at the bedside or on the floor, and critical are time spent. You can then also bill for time-based critical care 99291.
If the patient is under the age of 6 and you are billing for per diem critical care, you must delete the 99233 bill.
If the patient was critical for most of the shift and you are writing a single note with the critical care dotphrase, you should only bill for critical care and not for a level 3 subsequent visit.
Here is one scenario where it could work. You round on the patient in the morning, and she is stable / non-critical. You write a progress note and bill a level 3 subsequent visit 99233.
In the afternoon, she decompensates and an RRT is called. You provide 30 minutes of critical care during and after the RRT. You write a separate event note documenting the critical system failure, interventions provided at the bedside or on the floor, and critical are time spent. You can then also bill for time-based critical care 99291.
If the patient is under the age of 6 and you are billing for per diem critical care, you must delete the 99233 bill.
If the patient was critical for most of the shift and you are writing a single note with the critical care dotphrase, you should only bill for critical care and not for a level 3 subsequent visit.