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The error rate is high for critical care services, according to findings from the 2018 Comprehensive Error Rate Testing contractor.[1] Here are a couple pointers to help improve Medicare compliance, says Betsy Nicoletti, a consultant in Northampton, Massachusetts. Contact her at betsy@betsynicoletti.com.
CMS Rules Related to Critical Care That Are Not CPT Rules
CMS | CPT |
---|---|
The first hour (74 minutes) must be provided by one physician, before a second physician may use the add-on code 99292 | CPT is silent on this |
Physicians and nonphysician practitioners may not share critical care time | CPT is silent on this |
Two physicians may not bill for the same instance of time (8-9 am, for example) | CPT is silent on this |
One physician may not bill both ED codes 99281-99285 and critical care for the same patient on the same day | CPT is silent on this |