tci General Surgery Coding Alert - 2000 Issue 4

Increase Pay Up by Properly Using Critical Care Codes

CPT and Medicare have clarified and somewhat eased the stringent guidelines for critical care (99291-99292), but billing for these relatively well-reimbursed evaluation and management (E/M) services is still difficult for surgeons. Many of the procedures surgeons perform have a global package, which bundles most E/M services into the reimbursement for the procedure. In addition, when general surgeons see trauma patients and provide critical care services, other specialists often are involved as well. Consequently, the surgeon frequently cannot bill because only one involved physician can code for critical care, says Terry Fletcher, BS, CPC, an independent coding and reimbursement specialist...

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