tci ED Coding & Reimbursement Alert - 2017 Issue 11

News You Can Use: You Can No Longer Report ED Visits With Critical Care Codes

Even a modifier won't let you separate these edits. It's a common occurrence: The ED physician evaluates a patient by performing a complete E/M service, and then determines that the patient requires critical care services, which he administers. However, the days of billing both an ED E/M code and a critical care code will soon be gone forever. Effective Oct. 1, the Correct Coding Initiative (CCI) will bundle the ED visit codes (99281-99285) into critical care codes 99291-99292 and no modifier can separate the edits. Although the CCI has bundled these codes together for over a decade, the fact...

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