tci Medicare Compliance & Reimbursement - 2017 Issue 21

Industry Notes: Know These CCI Edits for ED Coding

It's a common occurrence: The emergency room physician evaluates a patient by performing a complete E/M service, and then determines that the patient requires critical care services, which are administered. However, the days of billing both an emergency department E/M code and a critical care code will soon be gone forever. On Oct. 1, the Correct Coding Initiative (CCI) started bundling 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 that the bundle indicator changed from "1"...

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