Wiki 2022 Split/Shared Visits

[rjmaus1965]

Am I correct in thinking that the only codes that are allowed to be billed as a Split (or Shared) are codes 99202-99215 (Other Outpatient) , 99217-99226 (Hospital Observation), 99221-99239 (Hospital Inpatient), 99281-99288 (Emergency Department) and 99291-99292 (Critical Care)? These are the specific E/M Visit Code Families stated within the CMS Claims Processing Manual Chapter 12 30.6.18 - Split (or Shared) Visits description. I'm seeing providers billing E/M Services for age 28 days or less,99460-99463, Critical Care Age 5 years or Younger, 99468-99476, and Initial Inpatient Neonatal Intensive Care and Other Services, 99477-99480, as a Split Shared Service. It doesn't appear to me that this is allowed from the code family descriptions and the fact that none of these codes require the key E/M visit components history, exam, or MDM. Would Split/Share be allowed for these codes if both providers documented their time? Does anyone have a source regarding this? Appreciate any feedback...

 

[jkyles]

CMS split/shared also applies to skilled nursing facility services.
(See the chart in the IOM).

Aside from critical care I haven't seen anything that lists specific codes but I always assumed the rule applied to the codes you listed (plus SNF services). However, I didn't know that Medicare covered neonatal services.