tci ED Coding & Reimbursement Alert - 2016 Issue 4

Critical Care: Double Check Your Time Statement before Assigning a Critical Care Code

Verify your time attestation statement for the best results. Critical care coding is an ever increasing major audit target and these claims tend to receive the closest scrutiny from claims reviewers. And the bad news doesn't end there. Caution: Some payers are going to prepayment audits to make sure the documentation is correct before paying for 99291 (Critical care, evaluation and management of the critically ill or critically injured; first 30-74 minutes). The ED E/M codes reported in the ED are assigned and audited using documentation guidelines. But that's not the case for the critical care codes. As a...

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