tci General Surgery Coding Alert - 2007 Issue 12

Reader Questions: Separate Critical Care Claims Could Lead to Denials

Question: Can two physicians claim critical care for the same patient? I can find nothing in Medicare policy disallowing this, but I-m reluctant to report these services. California Subscriber Answer: You-re probably correct to be wary of reporting simultaneous critical care services (99291-99296) for the same patient for more than one physician. You-re right that CMS has no national policy saying you can't bill for two doctors performing critical care during the same hour. But CMS leaves this issue up to the carriers, and some of them have policies that specifically say only one doctor can provide critical care...

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