Question

A 5 year-old is brought to the Emergency Department by ambulance, He had been found floating in a pool for an unknown amount of time. EMS started CPR which was continued by the ED provider along with endotracheal intubation and placement of a CVC. The ER provider spent 1 hour with the critically ill patient. The ED provider makes a notation the 1 hour does not include the time for the other separate billable services. What CPT® codes are reported?

Answer 1

According to CPT® guidelines: “The critical care codes 99291 and 99292 are  used to report the total duration of time spent by a physician providing critical care services to a critically ill or critically injured patient. Time spent with  individual patient should be recorded in the patient’s record.” According to  CPT® guidelines: “Services such as endotracheal intubation (31500) and  cardiopulmonary resuscitation (92950) are not included in the critical care  codes. Therefore, they can be coded separately in addition to critical care  

services if the critical care is a significant, separately identifiable service, and  is reported with modifier -25. The time spent performing these other services,

eg, endotracheal intubation, is excluded from the determination of the time  spent providing critical care.” In the CPT® Index, look for Cardiopulmonary  Resuscitation (CPR). You are referred to 92950. Review code to verify  accuracy. In the CPT® Index, look for Catheterization/Central. You are referred to 36555-36566. 36556 is the correct code because the patient is 5 years of  age and there is no indication the CVP was tunneled. In the CPT® Index, look  for Intubation/Endotracheal Tube. You are referred to 31500. Review code to  verify accuracy