tci Medicare Compliance & Reimbursement - 2013 Issue 12

Reimbursement: Are These 2 Misconceptions Costing You Critical Care Pay?

Crucial: You must meet vital time and documentation requirements. Regardless of the setting where a patient receives critical care, your claim will stand the best chances of success  if there is a high probability of imminent or life-threatening deterioration of the patient’s condition and you properly document the level of care. Myth 1: You Can Only Provide Critical Care in the Emergency Room If you think that your physician has to be in an emergency department (ED) or other critical care area, you may be missing out on well-deserved reimbursement for codes 99291 and +99292. In reality, a...

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