When appropriate, under the outpatient PPS, a hospital can use this CPT code in place of, but not in addition to, a code for a medical visit or emergency department service.

Question

Quizplus · Accepted Answer

CPT code 99291 (critical care) is used when a patient's condition is critical and requires continuous monitoring and interventions by a physician or other qualified healthcare provider. This code can be used instead of a code for a medical visit or emergency department service when appropriate. Codes 99358, 35001, and 50300 are not appropriate replacements for a medical visit or emergency department service.

When Appropriate, Under the Outpatient PPS, a Hospital Can Use