tci ED Coding & Reimbursement Alert - 2007 Issue 9

Reader Questions: 'Blanket' Policy May Smother Critical Care Pay

Question: Our compliance department is pressuring the ED coders to simplify critical care coding compliance by adopting our local Medicaid carrier's critical care policies across the board. That would make sure we-re all on the same page all the time, but what are the disadvantages? Minnesota Subscriber Answer: Using your local Medicaid's critical care guidelines to shape your critical care coding policies and procedures might ensure you-re compliant with every payer's rules, says Caral Edelberg, CPC, CCS-P CHC, who spoke at the American Academy of Professional Coders (AAPC) National Conference in Seattle. However, this "blanket approach" to compliance "guarantees...

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