tci ED Coding & Reimbursement Alert - 2014 Issue 11

Critical Care: You Must Meet Both The "Critical" Illness and the Time Thresholds To Accurately Report Critical Care

Review these strategies to avoid auditors’ scrutiny.  Critical care coding is often the target of payer audits -- and mistakes can cost you.  Because the critical care codes are unlike the other E/M codes reported in the ED typically using the 9928x code set in documentation requirements, these can be misunderstood by those unfamiliar with the rules that do apply. Check out these tips on what “critical” actually means and which services are, and are not, bundled into the critical care codes. Insurers May Not Agree That Your Patient Was Critically Ill or Injured  Whether the...

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