tci Part B Insider - 2018 Issue 8

E/M Coding: Strong Notes Back Up Critical Care Claims

Watch the clock for correct critical care coding. Part B clinicians sometimes treat 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. “A critical illness or injury acutely...

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