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Thread: Critical Care Clarification for Facility Side

  1. #1

    Question Critical Care Clarification for Facility Side

    AAPC: Back to School
    Can anyone please clarify for us on billing critical care services for the facility side. Are the CPT's that are inclusive of 99291 & 99292 inclusive for both the professional & the facility components. Example: 71010 would not be charged for the profee component but is it for the facility?

    We do split billing at our facility & another facility is stating they charge the facility portion for the codes but not the professional component & we do not charge either so would appreciate clarification & if you have a website reference that would be great. Thank you in advance.



  2. #2

    Default Billing for Critical care in hospitals

    We bill for the technical component here at Flagler Hospital. We do not employ our doctors so they bill their pro fee. We do bill that code, but be careful, there is a lot that is bundled in the critical care codes. E&M guidelines for Hospitals can be found at the July 2008 OPPS quarterly update Transmittal 1536. Change Request 6094 issued on June 19, 2008. And you can find the critical care guidelines on the MLN Matter article, MM5993. CR 5993 Release date 07/09/08. Feel free to call me at 904-819-4089. I am the chargemaster coordinator here. My name is Bill. I can fax you this stuff if you'd like.

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