tci ED Coding & Reimbursement Alert - 2001 Issue 6

News Brief: OIG Supports Application of Critical Care Codes in the ED

A recent Office of Inspector General (OIG) study reported that HCFAs concerns about physicians not properly using critical care codes are unwarranted. The OIG study was conducted in response to changes made to critical care code definitions in 1999 and 2001. HCFA expressed concerns that removing unstable from the critical care requirements, which were reworded to read high probability of survival is jeopardized, would induce ED practitioners and coders to bill critical care more heavily. To prevent overbilling of such services, HCFA decreased the relative value units for 99291-99292 in 2000. The study revealed, however, that emergency medicine accounted...

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