Don't factor NPP into your critical care code choice

Why This Topic Matters

Critical care coding often depends on time, so understanding which time may be counted affects code selection and claim compliance. The article helps readers recognize that payer policy, including Medicare guidance and local coverage determinations, may differ from general split/shared E/M billing assumptions.

Article Sections

1. Scenario and coding question

   Introduces the billing situation involving physician and non-physician practitioner services on the same day and frames the question about time counting for critical care code selection.

2. Medicare and CMS guidance

   Summarizes the Medicare perspective and CMS commentary on split/shared payment policy as it relates to critical care and other service categories.

3. Carrier and local policy perspectives

   Notes examples of local carrier approaches and the role of local coverage policies when national guidance is limited.

4. Professional society and consultant commentary

   Provides supporting viewpoints from professional organizations and coding consultants regarding critical care billing and time attribution.