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Ask a Rev Cycle Expert: Coding for Urgent and Critical Care?

Question:

If a patient goes to an Urgent Care center and receives care defined as critical care, can the Urgent Care center report Current Procedural Terminology (CPT®) codes 99291 CRITICAL CARE FIRST HOUR and 99292 CRITICAL CARE ADDL 30 MIN?

Answer:

Yes, the Urgent Care Center may bill for CPT® codes 99291 or 99292 Critical Care when the services defined as critical care are performed. Code selection is not dependent upon the site of service, but is dependent upon meeting the definition of being critical care.

Disclaimer: This information was current at the time of its publishing and is designed to provide accurate information in regard to the subject matter covered. Vitalware does not accept any responsibility or liability with regard to any errors, omissions, misuses, or misinterpretation by the reader. It is not intended to take the place of either the written policies or regulations. We encourage you to review the specific regulations and other interpretive materials as necessary. All CPT® codes are trademarked by the American Medical Association (AMA) and all revenue codes are copyrighted by the American Hospital Association (AHA).