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Thread: Critical Care Payment

  1. #1
    Join Date
    Apr 2007
    Carolina Coders

    Default Critical Care Payment

    AAPC: Back to School
    An interesting reimbursement scenario was brought to my attention today... apparently when CCT services are submitted 99291 by Dr. A and 99292 by Dr. B (same group-aggregate time critical care provided exceeds 74minutes); payers seem to be paying both claims per contracts.

    I have *always* believed that you should combine the time, select the correct code(s) and submit on a single claim under one provider. Now I see evidence that I may be wrong

    To all you CPC-P folks out there, have payment edits changed to allow for this style of reporting these services? If so, this can be of internal interest to physician groups who give "internal credit" for services provided.

    The reimbursement value remains the same.... but I am now very curious. Any takers?

    Charlotte NC
    Vice Chair, AAPCCA Board of Directors

  2. #2

    Default critical care under one provider


    I'm trying to locate the information when they decided that we had to bill under one provider for critical care. I know it's there but I can't find it.

    Is there anyone who can help me on this?

    thank you , help much appreciated.


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