What we bill · Critical care & inpatient
The revenue that happens at the hospital is the easiest to lose
Critical care time, ventilator management, and inpatient consults are high-value — and they occur away from the practice's own systems, where charges vanish. Here's where inpatient pulmonology billing breaks and what to demand.
Compare free quotesThe failure points
Where inpatient pulmonology revenue leaks
Time thresholds and bundling rules are specific and change — verify against current CPT and CMS guidance before billing.
Critical care time. 99291 covers the first 30–74 minutes and 99292 each additional 30 — but only if total critical care time is documented. Undocumented time is uncompensated time.
Procedures during critical care. Some procedures are separately billable from critical care and some are bundled into it. Getting this wrong means either lost charges or compliance exposure.
Ventilator management. Vent management and critical care can't simply be stacked without regard to the rules; the relationship has to be coded correctly.
Cross-site charge capture. Rounding notes and consults written in the hospital have to actually reach the biller. Without a disciplined capture process, they don't.
What to demand from a biller
Ask how they capture charges that originate in the hospital rather than your office, how they handle critical care time documentation, and how they decide when a same-day procedure is separately billable. A biller built around outpatient office visits will let your inpatient work slip through the cracks — and inpatient pulmonology is where the largest single-encounter values live.
Critical care billing, answered
What is CPT 99291?
99291 reports the first 30–74 minutes of critical care provided to a critically ill patient on a given day; 99292 reports each additional 30 minutes. Both are time-based and depend on the documented total critical care time.
Can critical care and procedures be billed the same day?
Sometimes — certain procedures are separately billable from critical care time, while others are bundled into it. The distinction is specific and documentation-dependent, so it should be reviewed rather than assumed.
Why do inpatient pulmonology charges get lost?
Usually charge capture: rounding, consults, and critical care time happen away from the practice's own systems, and without a disciplined process to pull them in, the notes never become claims.
Capture what happens at the hospital
Get competitive quotes, then ask each biller how they capture inpatient charges and document critical care time.
Compare free quotes
Takes 30 seconds. Free for practices. No obligation.
Free for practices. No obligation.