0098-Unbundling of Critical Care

Submitted by Matthew.Gregor… on Mon, 11/04/2019 - 07:45
Issue Number - Name
0098-Unbundling of Critical Care
Review Type
Automated
Claim Type
Professional Services
Region and State
Rac 1-4 <br/>All States
Date Approved
2018-06-12

Description

Certain services when performed on the day a physician bills for critical care are included in the critical care service and should not be reported separately.

Affected Code(s)

  • 93561, 93562, 71010, 71015, 71020, 99090, 43752, 91105, 94760, 94761, 94762, 92953, 94002, 94003, 94004, 94660, 94662, 36000, 36410, 36415, 36591 and 36600

Applicable Policy References

  • Social Security Act, Section 1833
  • CMS Pub. 100-04, Medicare Claims Processing Manual, Chapter 12, Section 30.6.12 (J)