critical care & CPR

[mrolf]

When billing critical care and CPR on the same date must you use a modifier on the cpt code for CPR??

Also if a patient was provided critical care and CPR on the same date why would Medicare deny paying the critical care and pay only the CPR?? Is the patient responsible for this if the hospital accepts assignment. Wouldn't the patient have had to sign a ABN in order to be responsible for payment when Medicare denies.

Please advise. Thanks.

 

[FTessaBartels]

25 modifier

You need a 25 modifier on the E/M if it is a significant, separately reportable service.

Hope that helps.

F Tessa Bartels, CPC, CEMC