Ask Dr. Z

Questioning if I can bill critical care. The patient encounter was created at 12:23 arrived in the ED department at 12:28 and there is no documentation stating that he was in contact with the EMT’s enroute to the hospital, so 12:28 would be the accurate start time and the family wanted CPR measures stopped at 12:52 and that was the time of death recorded in the nursing timeline. So this would only be 24 minutes of critical care time. The provider did not give me a start time or stop time or total time spent but a blanket statement of 30-74 minutes spent providing critical care (documentation template). The provider did receive lab results at 13:27, and the ET tube was removed at 13:49 and had a long discussion with the family, but at this point the resuscitation efforts were no longer being performed. This patient is Medicare, and the resources we found state that Medicare does not allow family discussions to be included in critical care after the patient has expired. Would I be correct in assigning the 99285 instead of 99291?