Critical care billing

[AG2284]

I am a private practice pulmonologist in NE . We do our own cc billing . We used to do 75+ mins of cc critical care billing and code 99291,99292.
Now , I hear we can only add 99292 after 104 mins ? Is that true ? Any recommendations to optimize cc billing

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[psychbender]

From what I understand, yes, that is accurate as of this year. One has to use the entire extra 30 minutes before being able to bill the 99292.

 

[chessknt]

I am a private practice pulmonologist in NE . We do our own cc billing . We used to do 75+ mins of cc critical care billing and code 99291,99292.
Now , I hear we can only add 99292 after 104 mins ? Is that true ? Any recommendations to optimize cc billing

It is true, CMS changed that at the start of the year as thanks for your service during covid 19.

I recommend you take 104 minutes to optimize billing--you get paid to be inefficient now since taking 102 minutes means you just worked 29 minutes for free. Also make sure to avoid advanced care planning discussions and perform as many intubations, lines, cpr etc. those all make way more money than talking about dying with dignity.

In all honesty the time changes made cc time valued less than clinic time. You could see 3 new patients in 104 minutes and bill more, way more if you have ancillary collections on pfts, labs or whatever.

 

[AG2284]

Thank you . But anything up to 104 mins is 99291( it was 75 mins before ) ? And you add 99292 once you reach 105 ?
We used to bill 75 mins for most new consults previously but are finding it hard to justify 105 mins for these pts to capture 99292.
I do my own lines and intubations , they don’t pay much per our billing company

 

[Tipsy McStagger]

I could be wrong but I think at the moment this only applies to Medicare patients.

But I suspect other insurers will follow if there’s an opportunity to pay less money.

 

[chessknt]

No this is everyone.

Cms says previously they use to round up from 1 minute to 30 now they swung the other way and round down to 0 on any number other than 30.

Intubation and a central line bill for more than the first 103 minutes of cc time now and about 7x as much as spending half an hour discussing code status.

 

[Siggy]

No this is everyone.

Cms says previously they use to round up from 1 minute to 30 now they swung the other way and round down to 0 on any number other than 30.

Intubation and a central line bill for more than the first 103 minutes of cc time now and about 7x as much as spending half an hour discussing code status.

That advanced care planning is rolled into critical care time. So unless that 30 minutes gets you to a -92, it's free time.

Ultimately the best money maker is the cardiac arrest that gets intubated and a blind central line that then dies a second time shortly after you finish your 30 minute note.

 

[SurfingDoctor]

Ultimately the best money maker is the cardiac arrest that gets intubated and a blind central line that then dies a second time shortly after you finish your 30 minute note.

We’re sorry for your loss… now pay up or we send the debt collectors!

 

[Siggy]

We’re sorry for your loss… now pay up or we send the debt collectors!

I work under the assumption that people are insured or noncollectable. I have no qualms squeezing every last dollar owed from insurance companies, including Medicare.

 

[SurfingDoctor]

I work under the assumption that people are insured or noncollectable. I have no qualms squeezing every last dollar owed from insurance companies, including Medicare.

I mean, it is an interesting system we built ourselves. But you can’t hate the players…