Results 1 to 4 of 4

Critical Care Coding Questions

  1. #1
    Default Critical Care Coding Questions
    New Call-to-action
    Physician A bills a critical care code.
    Physician B bills an E/M hospital initial or subsequent code for the same patient and the same day. Is this billable by both MD's?

    It is understood that rounding in the CC unit and billing a subsequent hospital care code is feasible as long as it in not related to an operative procedure (non-global care)but can 2 physicians from the same group bill on the same day for the separate services?

  2. Default
    Quote Originally Posted by Tonyj View Post
    Physician A bills a critical care code.
    Physician B bills an E/M hospital initial or subsequent code for the same patient and the same day. Is this billable by both MD's?

    It is understood that rounding in the CC unit and billing a subsequent hospital care code is feasible as long as it in not related to an operative procedure (non-global care)but can 2 physicians from the same group bill on the same day for the separate services?
    In the Medicare Claims Manual, it says
    When a hospital inpatient or office/outpatient evaluation and management service (E/M) are furnished on a calendar date at which time the patient does not require critical care and the patient subsequently requires critical care both the critical Care Services (CPT codes 99291 and 99292) and the previous E/M service may be paid on the same date of service.

    So you can bill a subsequent hospital care code, and later bill critical care if it becomes necessary, but not critical care followed by regular rounding visits by the same specialty.

  3. #3
    Default
    Thanks for the feedback.

  4. Default Specialist billing for ICU services while they primary also bills for ICU services.
    My provider is a Pediatric Infectious Disease specialist and she sees patients in the NICU or PICU to find the infectious diseases she was asked to consult by the primary physician. She bills for ICU services because she provides the services that are outlined in these ICU codes. She has taken responsibility of the childs health until she finds the infection. Her claims are getting denied because the Primary Provider billed for these services so now our claim is deemed "code billed by another provider". Any suggestions on what code we should use other than a 99233? This level is too low for all the service and documentation she provides.
    Last edited by dmrbilling; 10-24-2018 at 09:37 PM.

Similar Threads

  1. Critical care coding
    By mkndevh@msn.com in forum Medical Coding General Discussion
    Replies: 0
    Last Post: 08-02-2017, 09:57 AM
  2. Replies: 4
    Last Post: 10-19-2010, 09:37 AM
  3. Critical Care Coding
    By cathyflower in forum Emergency Department
    Replies: 11
    Last Post: 05-27-2010, 02:22 PM
  4. Critical care coding
    By Nancy Grisanti in forum Emergency Department
    Replies: 1
    Last Post: 02-03-2010, 11:45 AM
  5. critical care coding
    By poyersaug in forum Medical Coding General Discussion
    Replies: 2
    Last Post: 04-24-2009, 11:26 AM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •  
Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?

Login

Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.