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critical care code

Maqbool Posted Tue 24th of July, 2012 23:01:36 PM

ICU code:
If I see a patient as a neurologist in ICU in critical situation offcoarse, can I will for critical care code. I am just consultant not primary physician and critical care doctor is the primary attending.
ER code:
If I see a paatient in ER for stroke evaluation and patient is later admitted after my reccomendations, should I do ER code or inpatient code?

SuperCoder Answered Wed 25th of July, 2012 19:22:56 PM

Coding Requirements fro Critical Care

•Only one physician may bill for critical care services during any one single period of time even if more than one physician is providing care to a critically ill/injured patient.
•Physicians assigned to a critical care unit (hospitalist/intensivist) may not report critical care based on a “ per shift ” basis.
•Services cannot be reported as a split/shared service when performed by a physician and a qualified NPP of the same group practice.
•Physicians in the same group practice, with the same specialty, may not report 99291 for the same patient on the same calendar date.
•Concurrent care by more than one physician representative by different specialties is payable if the services meet critical care requirements, (i.e., must be medically necessary and non-duplicative.)
•Hospital emergency department services are not payable for the same date as critical care services when provided by the same physician or physicians of the same specialty.
•Critical care services will not be paid on the same calendar date that a physician reports an unbundled procedure with a global surgical period, unless the critical care is billed with modifier -25 to indicate a significant, separately identifiable E/M service was performed

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