tci E/M Coding Alert - 2023 Issue Q2

News You Can Use: Understand How MPFS Clarifies E/M Code Billing

Report 99291 with critical illness or injury. The most recent Medicare Physician Fee Schedule (MPFS) final rule included an important clarification on billing critical illness or injury. While most hospital/inpatient evaluation and management (E/M) services received revised descriptors in 2023, critical care stood fast. The definitions for 99291 (Critical care, evaluation and management of the critically ill or critically injured patient; first 30-74 minutes) and +99292 (… each additional 30 minutes (List separately in addition to code for primary service)) remain unchanged in 2023. Here’s what has and hasn’t changed for billing critical care codes, and other...

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