AHA Coding Clinic® for HCPCS - 2011 Issue 1; FOR your INFORMATION

Reporting Critical Care Services Under the Opps

In previous years including calendar year 2010, the Centers for Medicare and Medicaid Services (CMS) instructed hospitals to report critical care CPT codes in accordance with CPT guidance, unless instructed otherwise by CMS. In particular, hospitals were instructed by CMS that any of the services indicated by the CPT Editorial Panel to be included in the reporting of CPT code 99291 were not to be billed separately. This advice was recently revised by the AMA CPT Editorial Panel and therefore, as of January 1, 2011, hospitals are to report all of the ancillary services and their associated charges separately...

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