tci Medicare Compliance & Reimbursement - 2018 Issue 13

E/M Coding: Bolster Your Critical Care Claims with Rock-Solid Notes

Hint: Time factors heavily in determining critical care billing. Although it may not happen every day, Medicare providers do see patients whose conditions are so critical that the visit turns into a life or death situation. There are a few potential ways to code these visits, so it’s important to know all the options before you submit your bill. Definition: According to CMS, “critical care is defined as the direct delivery by a physician(s) medical care for a critically ill or critically injured patient,” states the Medicare Claims Processing Manual, Chapter 12, Section 30.6.12...

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