Dr Martin provided 1 hour and 20 minutes of critical care services to Jack Smithton who is in the Intensive Care Unit with acute respiratory distress syndrome?
Medical Coding
Procedure performed: Critical care services
Patient: Jack Smithton
Diagnosis: Acute respiratory distress syndrome
Date of service: [Insert date of service]
CPT code: 99292
Description of CPT code 99292: Critical care services, per hour; first hour
Reimbursement amount: Varies depending on the payer. For Medicare, the allowed amount for CPT code 99292 is $172.00.
Modifier used: -51 (Multiple procedures)
Explanation of modifier -51: Modifier -51 is used to indicate that multiple procedures were performed on the same day by the same physician. In this case, Dr. Martin provided 1 hour and 20 minutes of critical care services, which is equivalent to 2 hours of service. Therefore, modifier -51 is used to indicate that two units of CPT code 99292 were billed.
Total reimbursement amount: $344.00 (2 units of CPT code 99292 at $172.00 per unit)