tci Part B Insider - 2003 Issue 20

You Can Override Bundling Edits With 99291 - The Proper Modifiers Can Save Your Life

Life-threatening situations, tough decisions - and bundling edits - all come with critical care. When patient's lives are threatened, Medicare expects your doctor to do everything in his power to save the day, without billing for anything separately. But you can legitimately bill for some things on the same day as an episode of critical care, says Michael Miscoe, president of Practice Masters Inc. in Central City, Pa. You can only bill for E/M services on the same day as critical care (99291) if the services and diagnoses are completely separate, says Roger Holland, president of Utilization PRO in...

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