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Critical care, IP consultation & Bronchoscopy on the same day

SuperCoder Posted Mon 30th of November, 2009 13:08:20 PM

Please show us the best way to bill this claim. We have this type of claim often. All on the same day. 99255 Initial Hosp. Consultation/ High Complex, 99291 Critical Care First Hr. 99292 Critical Care additional over 60 mins.
31628 Bronchoscopy, 31500 Insert Emergency Airway? Thank You!

SuperCoder Answered Mon 30th of November, 2009 13:48:19 PM

A few more additional information is required to answer this query perfectly. We need to know whether both the inpatient consultation and the critical care (CC) service were provided by same or different physician, with same or different tax id no. (same or different specialty and group practice). Here we are assuming that the patient’s age is more than 71 months. But usually we can bill both the high complex visit (99255) for the consultant, and the CC service (99291 [for first 30-74 min of CC service], +99292 [once for each additional 30 min of CC service]) on the same day. Here we are assuming that the two visits are done on different time of the same day. 99291 cannot be billed more than once on a single day. Using the code +99292 will depend upon the total time of CC service provided on a single day (each 99292 code for every additional 30 min after the first 30-74 min). Along with these codes, any other separately identifiable procedure performed on the same day, such as bronchoscopy (31628) needs to be billed separately, and same goes for the code 31500 (emergency intubation) also, provided the patient is considered as “adult” (more than 71 months of age).

Therefore all the four codes can be used for billing on the same day, when the Consultation and Critical Care service is provided to an Inpatient person aged 71 months or older: 99291, +99292, 31628, 31500.

Please remember, 31500 cannot be used as a separate code when the patient is 29 days through 71 months of age. In that case the code 31500 is included within the CC service provided.

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