Q&A Consult with Critical Care

[Ddd]

Please clarify this as our office has two beliefs -- Can we bill Consult (99223 Mod 25) with Critical Care (99291)? Or is the rule ONLY 99291? Thank you - We have an electronically signed consult with the last sentence stating "thank you for giving us opportunity to consult on your critically ill gentleman - time spent 7:50 AM to 8:28 AM"

 

[Joni24walter]

i know with e/r and other types services if the patient inpatient it is included but i am not sure about the consultation.

 

[Tamara Lucus]

Critical care can be billed with another E/M service and that includes consults. There are no CPT guidelines or edits that say they can't be billed together. Your local MAC may have a policy on billing the two together. You may want to check with them. I would use caution in billing for both. Keep in mind the guidelines for a consultation. Also, look at the time between the E/M service and the critical care service. For example, if we did a consult that morning and then later that day had to perform critical care services we would report both.