tci Medicare Compliance & Reimbursement - 2016 Issue 7

Compliance: Teaching Physicians Must Meet Higher Critical Care Documentation Standards

Tip: Go by the book. The teaching physician section in the Centers for Medicare and Medicaid Services (CMS) critical care Transmittal 1548 from July 2008 has specific language relating to the requirements for how teaching physicians report critical care services, says Michael A. Granovsky, MD, FACEP, CPC, President of Logix Health, a national ED coding and billing company based in Bedford, MA. This transmittal seems to hold the teaching physician’s documentation of critical care to a specific standard and set of time counting criteria. “For CPT® codes determined on the basis of time, such as critical care...

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