tci Medicare Compliance & Reimbursement - 2007 Issue 20

PART B: Check With Your Local Carrier For Concurrent Critical-Care Coverage

2 doctors, simultaneous critical care could lead to denials.Myth: There's no national policy forbidding concurrent critical care, so you should just go ahead and bill for it.Reality: It's true that the Centers for Medicare & Medicaid Services 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 at a time.Example: National Government Services (formerly known as Empire Medicare) has a policy that states:...

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