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tci Medicare Compliance & Reimbursement - 2014 Issue 9

Part B Mythbuster: Don't Fall Victim to this Critical Care Myth

Location cuts both ways. A recent clarification on critical care services from the Centers for Medicare and Medicaid Services (CMS) should come as a major relief to your physicians as well a boost to reimbursement. Scenario: Your physician performs CPR for a non-responsive patient in the observation care unit of the hospital, where he attends to the patient for 30 minutes, and the patient is later moved to the ICU, where your physician sees her for another 75 minutes evaluating her need for a mechanical ventilator, feeding tube and accompanying sedation while she stabilizes. Your physician bills for 70...

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