Reader Questions:
Coder Carve-Outs Necessary for Spot-On Critical Care Claims
Published on Sat Nov 06, 2010
Question: The ED physician recently provided an extensive service for a critically ill patient who suffered an acute myocardial infarction (AMI). During the service, the physician performed the following services:Cardiopulmonary resuscitation (CPR) Cardiac outputElectrocardiogram (ECG) interpretation and reportChest X-raysPulse oximetry.Are all of these services considered part of the critical care package?Montana SubscriberAnswer: Some of the services you list are part of the critical care service, while others are not.Part of critical care: Cardiac output, chest X-rays, pulse oximetry.Separate from critical care: CPR, EKG interpretation. When you file, be sure to submit 92950 (Cardiopulmonary resuscitation [e.g., in cardiac arrest]) and 93010 (Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only) to represent these services. On your claim, be sure to carve out the time that the physician spent on these separately reportable services.For instance, let's say that the encounter you described lasted a total of 91 minutes; notes [...]