tci Part B Insider - 2013 Issue 27

Reader Question: 'DNR' Doesn't Always Equate to Critical Care

Question: We’ve heard that the patient code status (DNR, DNI, full code) is one of the items to take into account when deciding whether physician services are considered critical care or not. Is that true? Answer: The patient’s code status doesn’t dictate whether the service can be considered critical care and billed with 99291-+99292 (Critical care, evaluation and management of the critically ill or critically injured patient …) — that’s determined by the care that’s given. Remember the CPT® guidelines for critical care: “Critical care is the direct delivery by a physician(s)...

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